New Knee Bracing Materials and Designs incorporated to optimize function of the pathological knee

Transcription

1 New Knee Bracing Materials and Designs incorporated to optimize function of the pathological knee Andrew Torney Queensland State Manager DJO Global Orthotist B. Pros. Orth.

2 The presentation will cover: A review of basic knee anatomy and common pathologies that respond well to Orthotic intervention. A review of existing knee braces and how the mechanisms within those designs improve pathological knee function. The engineering and design principles involved in the design of DJO Global s new range of knee braces, and how this provides Clinicians with an advanced product that provides improved patient outcomes.

3 Knee Anatomy 101

4 Knee Anatomy 101

5 The Cruciate Ligaments

6 The Cruciate Ligaments

7 The Cruciate Ligaments

8 The Cruciate Ligaments ACL test Anterior Draw/Lachman s test

9 The Cruciate Ligaments Women are up to 10X more likely to suffer a non-contact ACL injury than men

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11 The Cruciate Ligaments

12 The Cruciate Ligaments

13 The Cruciate Ligaments

14 The Cruciate Ligaments

15 The Cruciate Ligaments

16 PCL injury

17 The Cruciate Ligaments PCL test Posterior Draw Test

18 The Meniscus Shock absorbers Protect the Articular Cartilage Medial: C-shaped Lateral: O-shaped

19 The Meniscus Shear forces Forceful knee movement whilst weight-bearing Different types of tear Bucket handle Transverse Torn horn Poor blood supply=poor healing

20 The Meniscus

21 Articular Cartilage

22 Uni-compartmental Osteoarthritis of the knee

23 The Patello-Femoral Joint The Patella: A thick triangular bone which articulates with the femur and covers and protects the front of the knee joint

24 The Patello-Femoral Joint Lateral condyle acts as a bony barrier Quadriceps contraction exerts a medial pull on the patella

25 The Patello-Femoral Joint The patella slides up & down the femoral groove on the end of the femur as the knee bends. The patella is designed to fit in the center of the groove Patella Groove

26 The Patello-Femoral Joint Quadriceps attaches on the patella 4 parts Vastus Lateralis Vastus Medialis Vastus Intermedius Rectus Femoris RF VL VMO Qceps tendon

27 Patello-Femoral Mal-Tracking VMO/VL imbalance Shallow Femoral Groove Patella Slips Sideways Out of Groove Pain & Inflammation

28 Patellar Tendonitis (aka Jumper s Knee) Excessive Jumping Activities (Basketball, Volleyball) Repeated Stress on Patellar Tendon Pain & Inflammation

29 Osgood-Schlatter Disease Bone Growth Outpaces Soft Tissue Growth Patellar Tendon Tight Across Joint Stress Transmitted to Tibial Tuberosity Pain & Inflammation Tibial Micro-fracture

30 Quadriceps Tendonitis Excessive Jumping Activities (Basketball, Volleyball) Repeated Stress on Patellar Tendon Pain & Inflammation

31 So where do Orthotists come in????

32 ACL 4 point pressure system

33 The Cruciate Ligaments ACL test Anterior Draw/Lachman s test

34 The Cruciate Ligaments PCL test Posterior Draw Test

35 PCL 4 point pressure system

36 What else is out there??

37 But this is not new technology!!!!

38 So what is new???

39 Reduces, the time spent near full extension which is the most at risk position Gradually adds posterior load to the tibia through extension Eliminates the hard end point of range at full extension

40 Where s the Evidence???

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42 Available in:

43 Available in:

44 Available in:

45 The Osteo-arthritic knee

46 3 Point bracing System Mechanics What are we trying to change? Uni-compartmental joint space narrowing

47 How does a 3 point brace achieve this? 3 point load shifts compressive knee joint forces from the degenerative compartment to the healthy compartment Generally fall into designs that either push or pull the knee center X Knee Center X Degenerative Compartment: Medial Lateral Side of Knee Pushed: Lateral Medial

48 4 Point leverage systems These models only unload the affected compartment when knee is in full extension

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51 Clinical Evidence of Efficacy of OA Unloading knee braces

52 Method and Results

53 Clinical Evidence of Efficacy of OA Unloading knee braces

54 Conclusions

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56 OA Adjuster 3 Off loading capability 9/10 Activity level 8/10 Price range - Premium Universal OA Key

57 OA Nano Universal OA Key Off loading capability 8/10 Activity level 8/10 Price range - Premium First brace ever to incorporated Magnesium and NanoMag

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60 OA Full Force Off loading capability 5/10 Activity level 8/10 Price range Mid range

61 Coming soon..

62 OA Reaction Web Off loading capability 3/10 Activity level 9/10 Price range Bottom end Entry level price Alternative to frame braces for active patients Easy to put on elderly demographic Available January 2015??

63 Anterior knee pain Patella maltracking/chondromalacia Osgood-Schlatters Patella Tendonitis Quadriceps Tendonitis

64 Anterior knee pain What have we used in the past?

65 Anterior knee pain A new and better way

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