(ACL) Injury Prevention Brace - Lawrence Technological University
Download
Report
Transcript (ACL) Injury Prevention Brace - Lawrence Technological University
1
Novel Design of an Anterior
Cruciate Ligament (ACL)
Injury Prevention Brace
Rachel Porter
Dan Greenshields
Justin Killewald
Lawrence Technological University
BME Senior Projects 1
Dr. Mansoor Nasir, Fall 2013
Faculty Advisor: Dr. Eric Meyer, PhD
Technical Advisor: Ken Cook, P.E.
2
Agenda
Problem
Objective
Need Statement
Current progress/Future plans
Background
Research plan
Knee Anatomy
Design Process
Knee Mechanics
Patent
Knee Injuries
Testing
ACL Injuries
Cost & materials
ACL Injury Mechanisms
Timeline
Tasks & responsibilities
Problem
Knee injuries account for approximately 60% of all sports related injuries. Nearly
half of those injuries occur to the ACL [1].
Extensive recovery time ~ 8-12 months
3
Need Statement
An improved knee brace for ACL injury prevention could help lower the injury
rate in athletes.
Short term benefits
In turn, this potentially could delay the onset of further knee complications later in
life.
Long term benefits
4
Design
ACL braces
Prevent hyperextension
Prevent valgus bending
Osteoarthritis braces
Unicompartmental loading
Include design characteristics of prevention braces
5
Knee Anatomy
Bones
Ligaments
Menisci
Cartilage
Muscles/tendons
6
[2] http://www.webmd.com/pain-management/knee-pain/picture-of-the-knee
Knee Motions
Sagittal
Flexion
Extension
Coronal/Frontal
Valgus bending
Varus bending
Axial
Internal rotation
External rotation
7
8
Knee Injuries
Bone fracture
Torn ligament
[7]
ACL
PCL
MCL
LCL
Torn meniscus
Lateral
Medial
Osteoarthritis
9
ACL Injuries
200,000 – 300,000 ACL injuries/year in the U.S. [3]
70% of injuries are non-contact [4]
Females are 3-10 times more likely to sustain injury [5]
Stop-jump landing and cutting [5]
Most common injury position: < 30° of flexion
http://bretcontreras.com/wp-content/uploads/q-angle-men-vs-women.jpg
ACL Injury Mechanisms
Internal rotation
Anterior shear of tibia
Compressive force causes tibial slipping (5500 N) [4]
Hyperextension
Foot planted as knee is hit from the front
Axial Load
Foot planted as body twists
Tension on ACL causes tearing
Valgus bending
Knee is angled towards center of body
10
Objective
Redesign OA brace hinge to prevent hyperextension, valgus bending, and axial
loading on the knee joint to protect the ACL
Research plan
Hinge design
Patent filing
Human subject testing
11
12
Current ACL Braces
Donjoy Defiance – clinically proven brace
Decreases ACL strain [6]
FourcePoint hinge
Protects against hyperextension and valgus bending
Worn by many college and NFL linemen
http://www.djoglobal.com/products/donjoy/defiance
Osteoarthritis Braces
Commonly used by elderly population
Medial compartment most affected by OA. [8]
Offload medial compartment to even the distribution on compartments
Unicompartmental loading
Medial/lateral
13
Modified Hinge Design
Polycentric gears Spider gears
Hypothesis
Lateral hinge = polycentric
Medial hinge = spider gear
Stainless Steel
Both hinges – prevent hyperextension
Medial hinge – shifts loading mechanism
Lateral hinge – prevent valgus bending
14
Modified Hinge Design cont.
Polycentric normal action
Compressive loading – flexed action
15
Patent Filing Process
http://www.uspto.gov/patents/process/index.jsp
16
Current Patent Search
Hundreds of knee brace patents
OA brace
ACL brace
Individual components patented
Hinge - consistent
Strap
Frame
17
Future Patent Filing
Our design has not been patented
Two different hinges on our brace
Start process in January
Finish and file in May
Could take years to get full patent approval
18
Institutional Review Board (IRB)
Department of Health and Human Services
Protect the rights and welfare of human subjects
Monitor research development, testing and evaluation methods
Submitted for IRB approval
Application
Consent form
Participant info sheet
19
http://www.irbservices.com/irbservices/Choose_IRBS_files/IRBS%20Master%20Logo.png
Current Testing Techniques
3D motion capture
20 participants
Stop-jump landings
20
With and without brace
Measured
Knee flexion angle
Ground reaction forces
[5]
21
Experimental Method
2 participants
Jump landing trials onto force plates
3 tests
Without brace
With Donjoy Defiance brace
With redesigned brace
Measure
Ground reaction force
Segment acceleration
Joint reaction force
Moment
Materials
Vicon Nexus
Polygon
http://bjsm.bmj.com/content/early/2010/06/16/bjsm.2009.069351/F2.large.jpg
Cost & Materials
Braces = $1000
Donjoy OA Defiance Brace
1 male and 1 female
Hinge redesign material = $500
Testing supplies = $300
Springs, screws, washers, stainless steel
Velcro, double sided tape
LESA foundation - $1000 granted
22
Timeline
Month
Milestone
January
Assemble first prototype brace and begin human subject testing
February
Continue testing prototype and adjust design
March
Adjust design and continue testing
Data analysis
April
Data analysis and interpretation
May
Prepare final report and presentation
File provisional patent
23
Anticipated Challenges
Not a significant decrease in compressive load forces
Time restrictions
Failed IRB approval
Patent filing
24
25
Tasks & Responsibilities
Individual tasks
Shared tasks
Rachel Porter
Prototype design & fabrication
Testing
Data analysis
Institutional Review Board (IRB) filing
Dan Greenshields
Existing knee brace patent search
Presentation creation
Patent application
Final report documentation
Justin Killewald
Hinge design research
Materials used in braces
References
[1] Rishiraj, Neetu, Jack E. Taunton, Robert Lloyd-Smith, Robert Woollard, William Regan, and D.B. Clement. "The
Potential Role of Prophylactic/Functional Knee Bracing in Preventing Knee Ligament Injury." Sports Medicine 39.11
(2009): 937-60. Print.
[2] http://www.webmd.com/pain-management/knee-pain/picture-of-the-knee
[3]Teng, Phillis S.P., K.F. Leong, P.Y. Huang, and J. McLaren. "The Effect of a Knee-ankle Restraint
on ACL Injury Risk Reduction during Jump-landing." Procedia Engineering60 (2013): 300-06. Print.
[4] Meyer, Eric G., and Roger C. Haut. "Excessive Compression of the Human Tibio-femoral Joint
Causes ACL Rupture." Journal of Biomechanics 38.11 (2005): 2311-316. Print.
[5] Yu, B. "Immediate Effects of a Knee Brace With a Constraint to Knee Extension on Knee
Kinematics and Ground Reaction Forces in a Stop-Jump Task." American Journal of Sports
Medicine 32.5 (2004): 1136-143. Print.
[6] http://www.djoglobal.com/education/patient-education/acl-bracing
[7] Majewski, M., H. Susanne, and S. Klaus. "Epidemiology of Athletic Knee Injuries: A 10-year
Study." The Knee 13.3 (2006): 184-88. Print.
[8] Gaasbeek, Robert D.A., Brenda E. Groen, Brieke Hampsink, Ronald J. Van Heerwaarden, and
Jacques Duysens. "Valgus Bracing in Patients with Medial Compartment Osteoarthritis of the Knee
A Gait Analysis Study of a New Brace." Gait & Posture26 (2007): 3-10. Print.
26
Questions?
27