Support orthopaedic device for a knee joint

Abstract

Support orthopaedic device ( 1 ) for a knee joint, comprising a proximal connector ( 2 ) and a distal connector ( 3 ), articulated among themselves and respectively intended to be associated with a proximal bone ( 100 ) and a distal bone ( 101 ) of a lower limb connected among themselves by a knee joint. The device comprises a first rod ( 4 a) and a second rod ( 4 b), which are hinged, according to hinging axes normal to a median excursion plane of the orthopaedic device ( 1 ), to the proximal connector ( 2 ) and to the distal connector ( 3 ) so as to form with them an articulated quadrilateral. The articulated quadrilateral is planarly mobile according to a plane parallel to the excursion plane between a configuration corresponding to an extended position of the knee joint and configurations corresponding to bendings of different entity of the knee joint; the relative motion imposed to the proximal and distal connectors ( 2, 3 ) by the articulated quadrilateral is consistent with the physiological movement of the knee joint.

The invention claimed is: 
     
       1. Support A support orthopaedic device for a knee joint, comprising
 a first anchoring device and a second anchoring device, the first and second anchoring devices being arranged to be integrally associated respectively with a proximal bone and a distal bone of a lower limb, and the proximal bone and the distal bone being connected among themselves by a knee joint,;  
 a proximal connector and a distal connector, the proximal connector and the distal connector being articulated among themselves and respectively intended operable to be directly connected to said first and a second anchoring devices,;  
 a first rod and a second rod hinged, according to hinging axes normal to a median excursion plane of the orthopaedic device, to the proximal connector and to the distal connector so as to form with them a four-bar linkage;, said four-bar linkage being planarly mobile according to a plane parallel to the excursion plane between a main configuration corresponding to an extended position of the knee joint and a plurality of secondary configurations corresponding to a different degree degrees of bending of the knee joint, the relative motion imposed to the proximal and distal connectors by the four-bar linkage being consistent with the physiological movement of the knee joint, 
 wherein said proximal connector presents, in correspondence with one of its distal ends, a includes a reference aperture defined therein at a distal end and normal to the excursion plane, the reference hole, normal to the excursion plane, intended aperture being operable to temporarily house a guide thread integral with the proximal bone to allow the accurate positioning of the proximal connector with respect to the bone, 
 wherein the device comprises a first means to lock arranged to allow the locking of the four-bar linkage in the main configuration or in any one of its secondary configurations, and 
 wherein at least one of the first and second rods has a comprises a first transversal threaded aperture defined therein, the first transversal threaded hole with aperture having an axis normal to the excursion plane of the device;, and the first means to lock comprising comprises a locking screw, insertable into the first transversal hole threaded aperture and into a slot of a first septum integral with one of the distal or proximal connectors;, said locking screw being clampable against a wall of the first septum to lock the four-bar linkage in a wanted configuration. 
 
     
     
       2. Orthopaedic The orthopaedic device  1  according to  claim 1 , wherein said proximal connector has comprises means to connect arranged to hold a longitudinal rail of the first anchoring device. 
     
     
       3. Orthopaedic The orthopaedic device according to  claim 1 , wherein said distal connector has comprises means to connect arranged to fasten the distal connector to a rigid half ring of the second anchoring device. 
     
     
       4. Orthopaedic The orthopaedic device according to  claim 1 , wherein the first rod and the second rod are crossed at least in the main configuration. 
     
     
       5. Orthopaedic The orthopaedic device according to  claim 4 , wherein the a ratio between the a distance between the hinging axes of the first and the second rods to the distal connector and the a distance between the hinging axes of the first and second rods to the proximal connector is comprised between 3.5 and 4.3. 
     
     
       6. Orthopaedic The orthopaedic device according to  claim 5 , wherein the a ratio between the distances of the hinging axes of the first rod and the distance distances of the hinging axes of the second rods rod is comprised between 0.9 and 1.1. 
     
     
       7. Orthopaedic The orthopaedic device according to  claim 6 , wherein the a ratio between the distance of the hinging axes of the first rod and the distance between the hinging axes of the first and second rods to the distal connector is comprised between 1 and 1.2. 
     
     
       8. Orthopaedic The orthopaedic device according to  claim 1 , wherein the first transversal hole threaded aperture is arranged on defined in the first rod, the first septum being is integral with the distal connector, parallel to the excursion plane of the device and contiguous to the first rod, and the slot having the has a shape of a circular arc with the a centre on the hinging axis of the first rod to the distal connector. 
     
     
       9. Orthopaedic The orthopaedic device according to  claim 1 , further comprising means to stop positionable to unilaterally limit the excursion of the four-bar linkage so as to limit the bending of the knee joint to a wanted angle. 
     
     
       10. Orthopaedic The orthopaedic device according to  claim 9 , wherein the means to stop comprise comprises a stop screw, the stop screw is insertable into a threaded stop hole integral with aperture defined in one of the proximal and distal connectors and with an axis parallel to the excursion plane of the device, and one end of the stop screw being is arranged to interfere by contact with at least one of the first and second rods, by limiting the excursion of the four-bar linkage. 
     
     
       11. Support A support orthopaedic device ( 1 ) for a knee joint, comprising a proximal connector ( 2 ) and a distal connector ( 3 ), the proximal connector and the distal connector being articulated among themselves and respectively intended operable to be directly connected to
 a first anchoring device and to a second anchoring device ( 5 ,  6 ), the first and second anchoring devices being arranged to be integrally associated respectively with a proximal bone ( 100 ) and a distal bone ( 101 ) of a lower limb, and the proximal bone and the distal bone being connected among themselves by a knee joint,;  
 a proximal connector and a distal connector, articulated among themselves and respectively intended to be directly connected to said first and a second anchoring devices; characterised in that it comprises 
 a first rod ( 4 a) and a second rod ( 4 b); said first and second rods ( 4 a,  4 b) being hinged, according to hinging axes normal to a median excursion plane of the orthopaedic device ( 1 ), to the proximal connector ( 2 ) and to the distal connector ( 3 ) so as to form with them an a four-bar linkagearticulated quadrilateral; linkage, said four-bar linkagearticulated quadrilateral linkage being planarly mobile according to a plane parallel to the excursion plane between a main configuration corresponding to an extended position of the knee joint and a plurality of secondary configurations corresponding to different degree of bendings of different entity degrees of bending of the knee joint, the relative motion imposed to the proximal and distal connectors ( 2 ,  3 ) by the four-bar linkagearticulated quadrilateral being consistent with the physiological movement of the knee joint, 
 wherein said proximal connector ( 2 ) presenting, in correspondence with one of its distal ends, a includes a reference aperture defined therein at a distal end and normal to the excursion plane, the reference hole ( 20 ), normal to the excursion plane, intended aperture being operable to temporarily house a guide thread ( 200 ) integral with the proximal bone ( 100 ) to allow the accurate positioning of the proximal connector with respect to the bone, 
 wherein the device comprises a second means to lock arranged to allow the locking of the four-bar linkage in a finite plurality of possible locking configurations, and 
 wherein at least one of the first and second rods has a comprises a second transversal aperture defined therein, the second transversal hole with aperture having an axis normal to the excursion plane of the device;, the second means to lock comprising comprises a second septum integral with one of the distal or proximal connectors, said second septum comprises a plurality of locking holes apertures defined therein, one of which the locking apertures of the second septum is aligned with the second transversal hole aperture at a possible locking configuration, and a pin being therefore is insertable through one of the locking holes apertures and the second transversal hole aperture to lock the four-bar linkage in the wanted locking configuration. 
 
     
     
       12. Support A support orthopaedic device for a knee joint, comprising a first anchoring device and a second anchoring device, the first and second anchoring devices being arranged to be integrally associated respectively with a proximal bone and a distal bone of a lower limb, and the proximal bone and the distal bone being connected among themselves by a knee joint,; a proximal connector and a distal connector, the proximal connector and the distal connector being articulated among themselves and respectively intended operable to be directly connected to said first and a second anchoring devices,; a first rod and a second rod hinged, according to hinging axes normal to a median excursion plane of the orthopaedic device, to the proximal connector and to the distal connector so as to form with them a four-bar linkage;, said four-bar linkage being planarly mobile according to a plane parallel to the excursion plane between a main configuration corresponding to an extended position of the knee joint and a plurality of secondary configurations corresponding to different degree degrees of bending of the knee joint, the relative motion imposed to the proximal and distal connectors by the four-bar linkage being consistent with the physiological movement of the knee joint, wherein said proximal connector presents, in correspondence with one of its distal ends, a includes a reference aperture defined therein at a distal end and normal to the excursion plane, the reference hole, normal to the excursion plane, intended aperture being operable to temporarily house a guide thread integral with the proximal bone to allow the accurate positioning of the proximal connector with respect to the bone; the device comprises means to stop positionable to unilaterally limit the excursion of the four-bar linkage so as to limit the bendings bending of the knee joint to a wanted angle, wherein the means to stop comprise comprises a stop screw, the stop screw is insertable into a threaded stop hole integral with aperture defined in one of the proximal and distal connectors and with an axis parallel to the excursion plane of the device, one end of the stop screw being is arranged to interfere by contact with at least one of the first and second rods, by limiting the excursion of the four-bar linkage; wherein the distal connector comprises two side walls which rise laterally in relation to a base to form a hinging bracket for the first rod and the second rod, said first and second rods both having comprise a first segment and a second segment, the respective first segments being hinged to the distal connector, with transversal extension equal to the distance between the side walls, and a the respective second segment, segments being hinged to the proximal connector, with reduced transversal extension compared to the first segment to allow crossing without interference of the two rods;, and the proximal connector comprising comprises two side-by-side brackets, inside which, according to parallel but and offset axis, the second segments of the first rod and the second rod are introduced and hinged. 
     
     
       13. A support orthopaedic device for a joint, comprising
 a first anchoring device operable to be integrally associated with a first bone;   a second anchoring device operable to be integrally associated with a second bone, the first and second bones being connected by a joint;   a first connector operable to be connected to the first anchoring device, a distal portion of the first connector having a reference aperture defined therein, the reference aperture being operable to receive a guide integrally associated with the first bone;   a second connector operable to be connected to the second anchoring device and to articulate with the first connector;   a first rod and a second rod hinged to the first connector and to the second connector to provide a four-bar linkage, the four-bar linkage having a main configuration corresponding to an extended position and a plurality of secondary configurations corresponding to different degrees of bending; and   a lock mechanism operable to lock the four-bar linkage in the main configuration or in any one of the secondary configurations, wherein   at least one of the first and second rods includes a threaded aperture defined therein, and   the lock mechanism includes a locking screw insertable into the threaded aperture and into a slot of one of the first and second connectors, the locking screw being clampable against a wall of the slot to lock the four-bar linkage.    
     
     
       14. The orthopaedic device according to claim 13, wherein the first connector includes a connector operable to hold a longitudinal rail of the first anchoring device.  
     
     
       15. The orthopaedic device according to claim 13, wherein the second connector includes a connector operable to fasten the second connector to a rigid half ring of the second anchoring device.  
     
     
       16. The orthopaedic device according to claim 13, wherein the first rod and the second rod are crossed at least in the main configuration.  
     
     
       17. The orthopaedic device according to claim 16, wherein a ratio between a distance between the hinging axes of the first and the second rods to the first connector and a distance between the hinging axes of the first and second rods to the second connector is between 3.5 and 4.3.  
     
     
       18. The orthopaedic device according to claim 16, wherein a ratio between distances of the hinging axes of the first rod and distances of the hinging axes of second rod is between 0.9 and 1.1.  
     
     
       19. The orthopaedic device according to claim 16, wherein a ratio between a distance of hinging axes of the first rod and a distance between hinging axes of the first and second rods to the second connector is between 1 and 1.2.  
     
     
       20. The orthopaedic device according to claim 13, wherein
 the threaded aperture is defined in the first rod, and   the slot has a shape of a circular arc with a centre on a hinging axis of the first rod to the second connector.    
     
     
       21. The orthopaedic device according to claim 13, further comprising a stop mechanism positionable to limit the excursion of the four-bar linkage.  
     
     
       22. The orthopaedic device according to claim 21, wherein
 the stop mechanism includes a stop screw,   the stop screw is insertable into an aperture defined in one of the first and second connectors, and   one end of the stop screw is positionable to interfere by contact with at least one of the first and second rods to limit the excursion of the four-bar linkage.    
     
     
       23. A support orthopaedic device for a joint, comprising
 a first anchoring device operable to be integrally associated with a first bone;   a second anchoring device operable to be integrally associated with a second bone, the first and second bones being connected by a joint;   a first connector operable to be connected to the first anchoring device, a distal portion of the first connector having a reference aperture defined therein, the reference aperture being operable to receive a guide integrally associated with the first bone;   a second connector operable to be connected to the second anchoring device and to articulate with the first connector;   a first rod and a second rod hinged to the first connector and to the second connector to provide a four-bar linkage, the four-bar linkage having a main configuration corresponding to an extended position and a plurality of secondary configurations corresponding to different degrees of bending; and   a lock mechanism operable to lock the four-bar linkage in a finite plurality of locking configurations, wherein   at least one of the first and second rods includes a threaded aperture defined therein,   the second connector includes a plurality of locking apertures defined therein,   one of the locking apertures of the second connector is aligned with the threaded aperture at a locking configuration, and   a pin is insertable through one of the locking apertures to the threaded aperture to lock the four-bar linkage.    
     
     
       24. A support orthopaedic device for a joint, comprising
 a first anchoring device operable to be integrally associated with a first bone;   a second anchoring device operable to be integrally associated with a second bone, the first and second bones being connected by a joint;   a first connector operable to be connected to the first anchoring device, a distal portion of the first connector having a reference aperture defined therein, the reference aperture being operable to receive a guide integrally associated with the first bone;   a second connector operable to be connected to the second anchoring device and to articulate with the first connector;   a first rod and a second rod hinged to the first connector and to the second connector to provide a four-bar linkage, the four-bar linkage having a main configuration corresponding to an extended position and a plurality of secondary configurations corresponding to different degrees of bending; and   a stop mechanism positionable to limit the excursion of the four-bar linkage, the stop mechanism including a stop screw, the stop screw being insertable into an aperture of one of the first and second connectors, and one end of the stop screw is positionable to interfere by contact with at least one of the first and second rods to limit the excursion of the four-bar linkage, wherein   the first connector includes two side walls that rise laterally in relation to a base to form a hinging bracket for the first rod and the second rod,   the first and second rods both include a first segment, hinged to the first connector, with transversal extension equal to the distance between the side walls and a second segment, hinged to the proximal connector, with reduced transversal extension compared to the first segment to allow crossing of the two rods, and   the second connector includes two side-by-side brackets, inside which, according to parallel and offset axis, the second segments of the first rod and the second rod are introduced and hinged.    
     
     
       25. A method of supporting a joint with an orthopedic support, comprising:
 providing a first anchoring device that is fixable to a first bone, a second anchoring device that is fixable to a second bone, and an articulated joint, the articulated joint having a reference aperture defined therein;   implanting the orthopedic support, the implanting including:
 inserting a guide into the first or second bone; 
 positioning the articulated joint to dispose the guide in the reference aperture; 
 anchoring the first anchoring device to the first bone; 
 anchoring the second anchoring device to the second bone; 
 coupling the articulated joint to the first and second anchoring devices; and 
   removing the guide from the first or second bone during the implanting step, wherein   the inserting includes inserting the guide in a femoral channel in a direction parallel to an articulation axis of a limb including the first and second bones.    
     
     
       26. A method of supporting a joint with an orthopedic support, comprising:
 providing a first anchoring device that is fixable to a first bone, a second anchoring device that is fixable to a second bone, and an articulated joint, the articulated joint having a reference aperture defined therein;   implanting the orthopedic support, the implanting including:
 inserting a guide into the first or second bone; 
 positioning the articulated joint to dispose the guide in the reference aperture; 
 anchoring the first anchoring device to the first bone; 
 anchoring the second anchoring device to the second bone; 
 coupling the articulated joint to the first and second anchoring devices; and 
   removing the guide from the first or second bone during the implanting step,   wherein the steps are performed in the order recited.    
     
     
       27. A method of supporting a joint with an orthopedic support, comprising:
 providing a first anchoring device that is fixable to a first bone, a second anchoring device that is fixable to a second bone, and an articulated joint, the articulated joint having a reference aperture defined therein;   implanting the orthopedic support, the implanting including:
 inserting a guide into the first or second bone; 
 positioning the articulated joint to dispose the guide in the reference aperture; 
 anchoring the first anchoring device to the first bone; 
 anchoring the second anchoring device to the second bone; 
 coupling the articulated joint to the first and second anchoring devices; and 
   removing the guide from the first or second bone during the implanting step, wherein   the first anchoring device includes a longitudinal rail.    
     
     
       28. The method according to claim 27, wherein the positioning includes positioning the articulated joint such that the guide passes through the reference aperture.  
     
     
       29. The method according to claim 27, wherein the anchoring the first anchoring device includes clamping the longitudinal rail to a bone screw inserted into the first bone.  
     
     
       30. The method according to claim 27, further comprising adjusting a clamp with respect to the longitudinal rail.  
     
     
       31. A method of supporting a joint with an orthopedic support, comprising:
 providing a first anchoring device that is fixable to a first bone, a second anchoring device that is fixable to a second bone, and an articulated joint, the articulated joint having a reference aperture defined therein;   implanting the orthopedic support, the implanting including:
 inserting a guide into the first or second bone; 
 positioning the articulated joint to dispose the guide in the reference aperture; 
 anchoring the first anchoring device to the first bone; 
 anchoring the second anchoring device to the second bone; 
 coupling the articulated joint to the first and second anchoring devices; and 
   removing the guide from the first or second bone during the implanting step, wherein   the second anchoring device includes a rigid partial ring.    
     
     
       32. The method of claim 31, wherein the anchoring the second anchoring device includes clamping the rigid partial ring to a bone screw inserted into an anterior surface of the second bone.