WO2006103430A1 - Appareil d'alignement prosthétique - Google Patents

Appareil d'alignement prosthétique Download PDF

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Publication number
WO2006103430A1
WO2006103430A1 PCT/GB2006/001149 GB2006001149W WO2006103430A1 WO 2006103430 A1 WO2006103430 A1 WO 2006103430A1 GB 2006001149 W GB2006001149 W GB 2006001149W WO 2006103430 A1 WO2006103430 A1 WO 2006103430A1
Authority
WO
WIPO (PCT)
Prior art keywords
support
socket
tilting
prosthetic
adjusting assembly
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/GB2006/001149
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English (en)
Inventor
Karyn Ross
Harry Kinsman
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
University of Strathclyde
Original Assignee
University of Strathclyde
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by University of Strathclyde filed Critical University of Strathclyde
Publication of WO2006103430A1 publication Critical patent/WO2006103430A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/76—Means for assembling, fitting or testing prostheses, e.g. for measuring or balancing, e.g. alignment means
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/60—Artificial legs or feet or parts thereof
    • A61F2/601—Peg legs, e.g. wooden legs
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
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    • A61F2/6607—Ankle joints
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/78—Means for protecting prostheses or for attaching them to the body, e.g. bandages, harnesses, straps, or stockings for the limb stump
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30495—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a locking ring
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical

Definitions

  • the present invention relates to an apparatus for adjusting the relative alignment of parts of a prosthesis.
  • the invention relates to an apparatus for adjusting and maintaining the alignment of a prosthetic member relative to a prosthetic socket.
  • the prosthesis typically consists of a socket portion which is worn on the residual limb, or "stump", and a prosthetic member portion, such as a foot or leg or the like which is fixed to the socket in a particular alignment determined for each patient individually.
  • a schematic illustration of an ankle disarticulation prosthesis, in use, is given in Figure 1 of the drawings.
  • an alignment unit may be provided between the prosthetic member and the socket, which may be adjusted in order to identify the optimum alignment for the patient to prevent damage or discomfort.
  • the alignment unit may be removed depending on the limb system, and the prosthetic member and socket fixed in position, in accordance with the alignment determined by the alignment unit, such that, in some cases, the foot is unable to move relative to the socket.
  • a number of types of alignment unit are currently in use; however, these suffer from a number of disadvantages when used at specific levels of amputation and with specific components. These may include:
  • the alignment device is used as a gauge or template, wherein the correct alignment is determined and temporarily set, with the unit sometimes being removed and the socket and foot being positionally fixed on a more permanent basis, which is obviously time consuming, with a possible loss in accuracy, and also limits or eliminates the possibility of future alignment alterations.
  • an apparatus for use in aligning and securing together parts of a prosthesis having a socket portion and a prosthetic member portion comprising first and second supports for securing to the socket portion and prosthetic member portion respectively, and an adjusting assembly adapted to be coupled between the first and second supports, wherein the apparatus permits the prosthetic member to be translated and tilted relative to the socket portion, the apparatus further comprising means for maintaining a relative alignment of the parts.
  • the apparatus may remain in situ between the prosthetic socket and member portions.
  • one of the supports may be adapted to be translated in a first direction with respect to the part of the prosthesis to which it is intended to be secured, and the same support may be adapted to be secured to the adjusting assembly in such a manner as to allow the adjusting assembly to be translated in a second direction with respect to the support.
  • one support defines at least one slot aligned in one required direction of translation, and at least one slot aligned in another required direction of translation, wherein, in use, a securing element such as a bolt or the like may extend through a respective slot and fixedly engage a respective prosthetic part and the adjusting assembly.
  • a securing element such as a bolt or the like may extend through a respective slot and fixedly engage a respective prosthetic part and the adjusting assembly.
  • the respective securing elements may be loosened to allow relative translation of the support, prosthetic parts and adjusting assembly, in the same directions as the respective slots, with the securing elements being re- tightened once the required adjustment has been made to retain the selected alignment.
  • the adjusting assembly comprises a plurality of adjusting elements which are arranged and assembled together to allow relative movement between respective elements to in turn allow one support to be manoeuvred and aligned relative to the other support, for example, by tilting, rotating or separation or the like.
  • the relative parts of the prosthesis may also be suitably aligned.
  • the apparatus may be secured between the socket and the prosthetic member, and the relative alignment between the socket and prosthetic member set in accordance with the comfort of the patient and suitability to the prosthetist. Once the correct alignment is achieved, this alignment may be preserved by the maintaining means such that the prosthetic member and socket are secured in the desired alignment.
  • the apparatus is adapted to permit the prosthetic member to be anteroposteriorly and mediolaterally translatable relative to the socket. That is, the apparatus is preferably adapted to permit relative planar translation of the parts of the prosthesis in two mutually perpendicular directions, namely forwards-backwards and side-to-side. Conveniently, this translation is permitted using anteropesterior and mediolateral slots in at least one of the support members.
  • the apparatus is adapted to permit the relative separation between the prosthetic member and socket portion to be adjusted.
  • the apparatus may be adapted to permit the prosthetic member to be rotated relative to the socket.
  • the adjusting assembly permits the prosthetic member to be tilted relative to the socket portion.
  • the adjusting assembly permits the prosthetic member to be anteroposteriorly and mediolaterally tilted relative to the socket portion.
  • the adjusting assembly permits adjustment of the relative separation of the parts of the prosthesis.
  • Relative planar translation of the prosthetic member and socket portion may also be permitted by the adjusting assembly.
  • relative planar translation may be achieved by manoeuvring at least one of the first and second supports relative to one or both the prosthetic member and socket.
  • One or both supports may be adapted to be secured to a respective one of the prosthetic member and socket portion by way of fixing screws or bolts or the like, or alternatively may be laminated or otherwise bonded thereto.
  • the first and second support structures may be similar or identical to each other.
  • the first and second supports may be secured to their respective prosthetic part in the same manner.
  • the first and second supports differ in structure and the method or mode in which they are secured to their respective prosthetic part may also differ.
  • the following description refers to the first and second supports as the prosthetic member support and the socket portion support, respectively.
  • these may be interchangeable such that features described below in relation to the prosthetic member support may be employed in the socket portion support, and vice versa.
  • the prosthetic member support comprises a plate having first and second opposing surfaces, wherein the first surface is adapted for engaging the prosthetic member, and the second surface is adapted for engaging the adjusting assembly.
  • the prosthetic member support defines a plurality of slots aligned with a respective required direction of translation.
  • the slots are adapted for accommodating securing means which, in use, extend through the slots to engage and fixedly secure the prosthetic member and adjusting assembly, respectively, to the prosthetic member support.
  • a relative alignment between the prosthetic member and prosthetic member support, and prosthetic member support and adjusting assembly may be selected and subsequently maintained by the securing means.
  • the securing means are releasable to allow readjustment of the relative alignment.
  • the securing means may be, for example, screws or nuts and bolts or the like.
  • the socket support defines a support surface for engaging the socket portion of the prosthesis.
  • the support surface is curved or bowl-shaped to accommodate the shape of the socket portion, which is conventionally dome-shaped.
  • the support surface may be of any suitable form or shape to accommodate the socket portion of the particular prosthesis being fitted.
  • the support surface may be cylindrical, conical, frusto-conical or the like and adapted to be at least partially surrounded or encased by the socket portion of the prosthesis.
  • the support surface of the socket support may comprise a surface relief to assist in engagement and retention with the prosthetic socket.
  • the surface relief may comprise ribs, studs, dimples or the like.
  • the support surface may define a profiled region adapted to engage a complimentary profiled portion on the prosthetic socket.
  • the complimentary profiles may therefore permit proper alignment to be achieved and retained.
  • the socket support may define apertures extending through the support surface for receiving screws or other like fixing means for securing the socket support to the socket.
  • the socket support may include at least one lug forming part of the support surface, wherein the aforementioned apertures may extend through the at least one lug.
  • the at least one lug may be suitably formed to allow the socket support to be secured to the prosthetic socket by means of adhesive bonding or lamination or the like.
  • the socket support is adapted to accommodate at least a portion of a prosthetic suspension system for securing the prosthesis to the patient.
  • the socket support may comprise securing means adapted to engage and secure a portion of a suspension system.
  • the securing means may comprise a ratchet assembly adapted to releasably engage a ratchet pin of a suspension system.
  • the ratchet pin may be secured to a sock, such as a silicone sock, worn by the patient, such that once engaged by the ratchet assembly the prosthesis becomes secured to the patient.
  • a sock such as a silicone sock
  • the ratchet assembly may be integrally formed with the socket support.
  • the ratchet assembly is separately formed and mounted on or within the support.
  • the ratchet assembly is mounted within a recess formed within the socket support.
  • the apparatus further comprises a retaining plate adapted to be secured to the socket support to retain the ratchet assembly within the recess.
  • the plate may be threadably coupled to the socket support, or alternatively may be secured using screws, bolts, rivets, a bayonet type fitting, magnetic fitting or the like.
  • the retaining plate defines an aperture adapted to permit a ratchet pin to pass therethrough to engage the ratchet assembly.
  • the retaining plate may define a concave or dished upper surface adapted to guide the ratchet pin towards the aperture upon fitting of the apparatus of the present invention in conjunction with a prosthesis.
  • the socket support defines an aperture providing external access to the recess to permit a releasing tool, such as a pin or the like, to engage the ratchet assembly to release the ratchet pin therefrom.
  • the ratchet assembly may be or comprise a shuttle type lock adapted to receive and engage a shuttle pin or magnetic interface or the like.
  • the socket support is adapted to be coupled to the adjusting assembly by means of a threaded connection, wherein the socket support includes a threaded portion and the adjusting assembly includes a corresponding threaded portion.
  • the threaded portion of the socket support may define a male thread and the threaded portion of the adjusting assembly may define a female thread, or vice versa.
  • the threaded portion of the socket support may be available in varying lengths to allow a larger range of adjustment of the relative separation between the prosthetic member and socket portion.
  • the adjusting assembly may comprise a threaded collar which is adapted to be threadably coupled to both the socket support and the remaining portion of the adjusting assembly.
  • the threaded collar includes an internal thread for engaging with one of the socket support and remaining portion of the adjusting assembly, and an external thread for engaging with the other of the socket support and remaining portion of the adjusting assembly.
  • threaded collars of varying sizes may be utilised to accommodate a larger range of available adjustment in the relative separation of the parts of the prosthesis.
  • the provision of a threaded collar as described above may allow the adjustment of the relative separation by rotation of the collar alone, without disturbing the relative rotational alignment of the socket and prosthetic member supports.
  • the threaded collar includes an outwardly facing lip which in use engages with a corresponding lip on the remaining portion of the adjusting assembly, wherein said engagement prevents over insertion of the collar into the remaining portion of the adjusting assembly.
  • the adjusting assembly comprises a tilting element and a tilting carriage.
  • the tilting element defines an outwardly facing curved surface
  • the tilting carriage defines a complementary inwardly facing curved surface adapted to engage with the curved surface of the tilting element.
  • the engagement of the complementary curved surfaces may be described as a ball and socket type arrangement, wherein the tilting element may be tilted relative to the tilting carriage through sliding engagement of the curved surfaces.
  • the tilting element is, in use, mounted on or secured to one of the socket support and prosthetic member support, and the tilting carriage is mounted on or secured to the other of the socket support and prosthetic member support.
  • one or both of the tilting element and tilting carriage may be integrally formed with a respective support.
  • the socket support is coupled to the tilting element, either directly or via a suitable threaded collar, as described above.
  • the tilting carriage is mounted on the prosthetic member support.
  • the tilting carriage is prevented from rotation relative to the prosthetic member support. This may be achieved by providing two or more apertures in the tilting carriage which receive bolts or pins or the like which also engage the prosthetic member support.
  • the bolts or pins or the like extend through the translation slots in the prosthetic member support.
  • the bolts or pins or the like may additionally be used to secure the adjusting assembly to the prosthetic member support.
  • the adjusting assembly further comprises a locking element adapted for maintaining at least a relative separation of the socket support relative to the prosthetic member support.
  • the locking element may additionally be adapted to maintain or assist in maintaining a relative tilt angle of the tilting element and tilting carriage.
  • the locking element may be integrally formed with the tilting element.
  • the locking element may be separately formed and, in use, may be mounted on the tilting element.
  • the locking element may be mounted on an outer surface of the tilting element and may be adapted to be fixed or coupled thereto.
  • the locking element is of a general ring-shape having an inner facing surface adapted to engage an outer surface of the tilting element.
  • the term 'ring' as used herein should not be limited to a body of circular form, but should include any geometric shape such as ovoid, triangular or polygonal or the like.
  • the locking element may be coupled to the tilting element by, for example, interference fit, threaded means or using additional fixing means such as bolts or screws or the like.
  • the locking element is adapted to be clamped to the tilting element.
  • the locking element may define a split or gap extending between inwardly and outwardly facing surfaces of the locking element, wherein the split or gap may be reduced in order to reduce the effective inner perimeter of the locking element, thus causing the locking element to clamp to the tilting element when mounted thereon.
  • the split or gap in the locking element may be varied by means of a threaded assembly extending across the gap from one side to the other.
  • the threaded assembly may be a nut and bolt type arrangement or the like.
  • the locking element defines an inwardly extending lip adapted to engage an upper surface of the tilting element such that, in use, the tilting element is prevented from upward movement relative to the locking element, when the apparatus of the present invention is orientated in an upright position.
  • the adjusting assembly is arranged such that, in use, the tilting carriage is positioned between the prosthetic member support and the tilting element.
  • the adjusting assembly is secured to the prosthetic member support by securing means extending between the prosthetic member support and the securing element such that the tilting element and tilting carriage are secured or clamped between the inwardly projecting lip of the locking element and the prosthetic member support.
  • the securing means also extend through apertures in the tilting carriage to prevent said tilting carriage from rotating relative to the prosthetic member support.
  • the securing means extend through the appropriate slots in the prosthetic member support.
  • the securing means permit adjustment of the tilt alignment between the tilting element and tilting carriage, as discussed below.
  • the securing means may be released and tightened to allow adjustment of the translation and tilting of the parts of the prosthesis, while securing the adjusting assembly to the prosthetic member support.
  • relative adjustment of the securing means extending between the locking element and the prosthetic member support may be used as a means of adjusting the tilting alignment between the tilting element and tilting carriage.
  • the securing means may be one or more nut and bolt arrangements or the like.
  • the tilting alignment of the tilting element and tilting carriage may be adjusted by means of one or more grub-type screws extending through a respective threaded aperture in the locking element and engaging a surface of the prosthetic member support or the tilting carriage. In this way, the at least one grub-type screw may be adjusted within its threaded aperture to cause the locking element, and thus tilting ring, to tilt relative to the tilting carriage.
  • the adjusting assembly is secured to the prosthetic member support by two diametrically opposed nut and bolt arrangements, and the locking element carries two diametrically opposed grub-type screws, disposed approximated 90° from each of the nut and bolt arrangements.
  • the tilting element is of a general ring shape defining inner and outer surfaces.
  • a portion of the outer surface is adapted to engage the tilting carriage and another portion of the outer surface is adapted to engage the locking element, as described above.
  • the inner surface is threaded to receive a threaded collar or a threaded portion of the socket support.
  • the tilting element defines a split or gap extending between the inner and outer surfaces, such that, when a locking element is clamped to the tilting element, for example as described above, the tilting element will be caused to clamp either the threaded collar or the socket support, thus preventing any rotation between the respective threads. In this way, clamping the locking element to the tilting ring will maintain the relative separation of the socket support and adjusting assembly.
  • the collar also defines a split or gap extending from the inner to outer surface such that, in a similar fashion as described above, when the locking element is clamped against the tilting ring, the collar will be caused to be clamped against the socket support, thus preventing any relative rotation therebetween.
  • the tilting element further defines at least one aperture extending into the outer curved surface thereof.
  • a tool may be inserted into the at least one aperture and used to rotate the tilting element relative to the tilting carriage.
  • the relative rotational alignment of the prosthetic supports may be adjusted, and once a preferred alignment is achieved, this may be maintained by clamping the tilting element and tilting carriage between the locking element and prosthetic member support.
  • the apparatus is intended for use with any lower limb prosthesis; such a prosthesis has a socket for fitting over a patient's stump, and a prosthetic member in the form of, for example, a prosthetic foot, knee or leg or the like.
  • the apparatus may be used in any prosthesis which requires a specific alignment between parts of the prosthesis to be set and maintained.
  • a prosthesis comprising: a prosthetic socket; a prosthetic member; and an apparatus for aligning and securing together the prosthetic socket and prosthetic member, the apparatus comprising first and second supports for securing to the socket portion and prosthetic member portion respectively, and an adjusting assembly adapted to be coupled between the first and second supports, wherein the apparatus permits the prosthetic member to be translated and tilted relative to the socket portion, the apparatus further comprising means for maintaining a relative alignment of the parts.
  • the prosthesis is an ankle disarticulation prosthesis, wherein the prosthetic member is a prosthetic foot.
  • the prosthesis is a knee disarticulation or transfemoral prosthesis, wherein the prosthetic member is a prosthetic knee.
  • the prosthesis is a transtibial prosthesis, wherein the prosthetic member is a prosthetic lower leg.
  • Figure 1 is a schematic illustration of a prosthetic foot being worn by a patient
  • Figure 2 is an exploded view of an apparatus according to an embodiment of an aspect of the present invention
  • Figure 3 is a perspective view of the apparatus of Figure 2, shown assembled;
  • Figure 4 is a cross-sectional view of the assembled apparatus shown in Figure 3, taken along line 4-4;
  • Figure 5 is a cross-sectional view of the assembled apparatus shown in Figure 3, taken along the line 5-5;
  • Figure 6 is an exploded view of an apparatus according to a modified embodiment of an aspect of the present invention.
  • Figure 7 is a perspective view of an ankle disarticulation prosthesis incorporating an apparatus in accordance with an embodiment of the present invention
  • Figure 8 is an enlarged view of the apparatus shown in Figure 7;
  • Figure 9 is a perspective view of a knee disarticulation prosthesis incorporating an apparatus in accordance with an embodiment of the present invention.
  • Figure 10 is an enlarged view of the apparatus shown in Figure 9;
  • Figure 11 is a perspective view of a transtibial prosthesis incorporating an apparatus in accordance with an embodiment of the present invention;
  • Figure 12 is an enlarged view of the apparatus shown in Figure 11;
  • Figure 13 is an exploded view of an apparatus in accordance with an alternative embodiment of the present invention
  • Figure 14 to 17 are views of components of the apparatus of Figure 13;
  • Figure 18 is a view of the apparatus of Figure 13 when assembled
  • Figure 19 is a view of a portion of the apparatus of Figure 13 shown attached to a prosthetic socket.
  • Figure 20 is a view of the apparatus of Figure 13 shown attached to a prosthetic socket.
  • FIG. 1 shows a schematic illustration of an ankle disarticulation prosthesis being worn by a patient.
  • the prosthesis 82 consists of two main parts, a socket 68 and a foot 66.
  • the socket 68 fits over and is worn on the patient's leg 76, which has been amputated at the ankle.
  • an alignment unit 78 is located between the socket 68 and the foot 66, which connects the socket 68 and foot 66, and is used to make adjustments to the relative orientation of the socket 68 and foot 66.
  • the alignment unit 78 may be removed and will act as a template to fix the alignment of the parts of the prosthesis in a more permanent manner. This operation may be time consuming and may result in a loss in accuracy, and also limits or substantially eliminates the possibility of future alignment alterations.
  • FIG. 2 an exploded view of an apparatus 100 for use in aligning and securing together parts of a prosthesis (not shown) including a prosthetic socket and a prosthetic member such as a foot or lower leg or the like.
  • the apparatus 100 includes a prosthetic member support 102, a socket support 104, and an adjusting assembly 106 positioned between the supports 102,
  • the form of the supports 102, 104 and adjusting assembly 106 permit the prosthetic member to be translated, tilted and rotated relative to the prosthetic socket and also permit adjustment of the relative separation of the prosthetic member and socket, as discussed below. Additionally, once the relative alignment of the prosthetic socket and member is achieved, this may be maintained by the apparatus 100, such that the apparatus 100 may remain in place during normal use of the prosthesis.
  • the member support 102 defines two slots 108 aligned in a mediolateral direction of translation. These mediolateral slots 108 receive respective bolts 110 which, in cooperation with nuts 112, engage and secure the adjusting assembly 106 to the prosthetic member support 102.
  • the nuts 112 and bolts 110 may be loosened to allow the adjusting assembly 106, and thus socket support 104, to be mediolaterally translated with respect to the member support.
  • the nuts and bolts 112, 110 may be re-tightened to maintain the adjusted alignment.
  • the slots 108 allow an approximate range of translation of 20 mm.
  • the member support 102 additionally defines five slots (only four visible in Figure 2) aligned in an anteroposterior direction of translation. Specifically, support
  • the central slot 114 is intended to be used in securing the apparatus 100 to a prosthetic component, wherein a bolt (not shown) extends upwardly from the prosthetic component through the slot 114 to engage a nut 118 which is specially adapted to slide within the slot 114.
  • Nut 118 has a rib 119 on its lower surface which in use engages a complementary recess in the prosthetic component to prevent relative rotation of the member support 102 and prosthetic component.
  • the outer slots 116 are intended to be used in securing the apparatus 100 to a prosthetic leg or knee joint wherein specialised screws extend downwardly through the slots 116 to engage the prosthetic leg or knee.
  • the appropriate bolt or screws extending through the slots 114, 116 may be loosened to allow the entire apparatus to be anteroposteriorly translated with respect to the prosthetic member (in this case, foot, leg or knee).
  • the central slot 114 allows an approximate range of translation of 20 mm
  • the outer slots 116 allow an approximate range of translation of 10 mm.
  • the socket support 104 defines a bowl-shaped inner surface 120 to accommodate the shape of the socket portion of the prosthesis, which is conventionally dome- shaped.
  • Support 104 includes four lugs 122, each of which defines two holes 124 for receiving screws to secure the prosthetic socket to the socket support 104.
  • the lugs 122 may alternatively be used to allow the socket support 104 to be laminated or otherwise suitably bonded to the prosthetic socket.
  • the socket support 104 includes a lower, externally threaded cylindrical portion 126 which allows the socket support 104 to be threadably coupled to the adjusting assembly 106, as discussed below.
  • the adjusting assembly 106 includes a collar 128 which is both internally and externally threaded. The internal thread of the collar 128, in use, is engaged with the external thread of the socket support 104.
  • the adjusting assembly further includes a tilting ring 130 which includes an internal thread, which in use is engaged with the external thread of the collar 128.
  • the threaded connection between the socket support 104, collar 128 and tilting ring 130 allows the relative separation of the socket support 104 and adjusting assembly 106, and thus the relative separation of the parts of the prosthesis, to be adjusted.
  • the embodiment shown allows adjustment of approximately 10 mm in the relative separation of socket support 104 and adjusting assembly 106.
  • a larger collar 140 may be used to provide a larger range of adjustment, as required.
  • the tilting ring 130 is positioned to be clamped between a locking ring 142 and a tilting ring carriage 144. More specifically, the tilting ring is clamped between an inwardly projecting lip 146 of the locking ring 142 and the tilting ring carriage 144. Clamping is achieved by the bolts" 110 which extend through respective holes 148, 150 in the locking ring 142 and tilting ring carriage 144, which are secured by nuts 112.
  • the locking ring 142 includes a circumferential gap 152, with a threaded lug 154 located on either side thereof.
  • a bolt 156 is arranged to extend through the threaded lugs 154, wherein tightening the bolt 156 causes the gap 152 to close, and loosening the bolt 156 causes the gap 152 to open. This arrangement allows the locking ring 142 to be circumferentially clamped to an outer surface of the tilting ring
  • the tilting ring 130 and collar 128 also include respective circumferential gaps 158, 160, such that clamping the locking ring 142 to the tilting ring 130 causes the tilting ring 142 to be circumferentially compressed by virtue of gap 158, which in turn compresses the collar 128 by virtue of the gap 160, which ultimately results in the collar 128 clamping against the socket support 104.
  • This has the effect of locking all threaded portions of the adjusting assembly 106 in order to maintain the separation between the adjusting assembly 106 and socket support 104.
  • the tilting ring 130 defines an outwardly facing curved surface 162, and the tilting ring carriage 144 defines a complementary inwardly facing curved surface 164 adapted to engage with the curved surface 162.
  • the engagement of the curved surfaces 162, 164 may be described as a ball and socket type arrangement, wherein the tilting ring 130 may be tilted relative to the tilting carriage 150 through sliding engagement of the curved surfaces 162, 164.
  • the anteroposterior tilt angle between the tilting ring 130 and tilting ring carriage 144 is adjusted using the bolts 110 and nuts 112.
  • the mediolateral tilt angle is adjusted using diametrically opposed grab screws 166 which extend through respective threaded apertures 168 in the locking ring 142 and engage a respective surface area 170 (only one visible in Figure 2) on the tilting ring carriage 144.
  • the grub screws 166 may be adjusted within the threaded apertures to cause the locking ring 142, and thus tilting ring 130 to be tilted relative to the tilting carriage 144.
  • the apparatus 100 of Figure 2 is capable of anteroposterior and mediolateral tilting in a range of approximately 20 degrees.
  • the apparatus 100 is shown fully assembled in Figure 3. As shown, the apparatus 100 provides a compact assembly which allows easy access to all points of adjustment. This allows the apparatus 100 to be more readily an easily adjusted by a prosthetist during fitting of a prosthesis to a patient.
  • Figure 4 is a cross-sectional view of the assembled apparatus as shown in Figure 3, taken along line 4-4
  • Figure 5 is a cross-sectional view of the assembled apparatus as shown in Figure 3, taken along line 5-5.
  • the collar 128 includes an outwardly projecting lip 184, which in use engages an inwardly projecting lip 186 of the tilting ring 130 to prevent the collar 128 from being over inserted into the tilting ring 130.
  • the nuts 112 are selectively loosened or tightened, as appropriate, on a respective bolt 110, in order to cause sliding engagement of the curved surfaces 162, 164 of the tilting ring 130 and carriage 144.
  • Adjustment of the mediolateral tilting alignment is achieved by adjusting the grub screws 166, shown in Figure 5, against the respective surface areas 170 of the tilting ring carriage 144.
  • Mediolateral translation of the apparatus 100 is achieved by loosening the nuts and bolts 112, 110 ( Figure 4) and translating the adjusting assembly 106 and socket support 104 with respect to the member support 102 in the direction of slots 108.
  • Anteroposterior translation of the apparatus 100 is achieved by loosening the central bolt (not shown) and nut 118 and translating the entire apparatus 100 in the direction of the central slot 114. In each case, the adjusted translation may be maintained by re- tightening the respective nuts/bolts.
  • Rotational alignment of the supports 102, 104 is achieved by the provision of a number of apertures 190 extending into the outer curved surface 162 of the tilting ring 130, wherein a suitable tool is inserted into one of the apertures 190 and used to rotate the tilting ring 130 relative to the tilting ring carriage 144.
  • This arrangement allows the relative rotational alignment to be adjusted without interfering with the separation alignment of the supports 102, 104.
  • Figure 7 shows an ankle disarticulation prosthesis 200 wherein an apparatus 100 according to the present invention is positioned between a prosthetic socket 202 and a prosthetic foot 204.
  • An enlarged view of the apparatus 100 positioned between the prosthetic socket and foot 202, 204 is shown in Figure 8.
  • the apparatus 100 may be used in a knee disarticulation or transfemoral prosthesis 300, as shown in Figure 9, wherein the apparatus 100 is positioned between a prosthetic socket 302 and a prosthetic knee/lower leg 304.
  • An enlarged view of the apparatus 100 positioned between the prosthetic socket and knee/lower leg 302, 304 is shown in Figure 10.
  • the apparatus 100 may be used in a transtibial prosthesis, such as that shown in Figure 11, generally represented by numeral 400. In this prosthesis, the apparatus 100 is positioned between a prosthetic socket 402 and a prosthetic lower leg/foot portion 404.
  • An enlarged view of the apparatus 100 positioned between the prosthetic socket and lower leg/foot 402, 404 is shown in Figure 12.
  • FIG. 13 there is shown an exploded view of an alignment apparatus, generally designated by reference numeral
  • the apparatus 500 for aligning and securing together parts of a prosthesis (not shown).
  • the apparatus 500 comprises an adjusting assembly similar to that first shown in Figure 2, and as such the adjusting assembly of Figure 13 is also indicated by reference numeral 106.
  • the adjusting assembly 106 is shown mounted on the prosthetic member support 102.
  • the apparatus 500 further comprises a prosthetic socket support 502 which, like the support 104 first shown in Figure 2, comprises an external threaded portion 504 for securing the support 502 to the adjusting assembly 106.
  • the socket support 502 defines a generally cylindrical socket support surface 506 for engaging with and securing to a prosthetic socket (not shown).
  • the prosthetic socket is moulded around the surface 506 of the socket support 502.
  • the support surface 506 comprises a pair of circumferential ribs 508 to assist in engagement and retention with the prosthetic socket.
  • the socket support 502 defines a circular recess " 510 which, in use, is adapted to receive a shuttle type lock ratchet 512 (Figure 13).
  • the ratchet 512 is shown located in the recess 510 of the socket support 502 in Figure 15.
  • the ratchet 512 is adapted to releasably receive a ratchet shuttle pin 514 which comprises an upper thread 516 to be secured to a silicone sock (not shown) fitted to the residual limb of the patient, and a series of ratchet ribs 518 for engaging the ratchet 512.
  • the present embodiment of the invention is adapted for use with a silicone suction suspension system.
  • the socket support 502 defines a lateral bore 520 extending through the socket support surface 506 which provides external access to the recess 510 to permit a releasing pin 52 to engage the ratchet 512 to release the ratchet pin 514 therefrom.
  • the apparatus 500 further comprises a retaining plate 524 adapted to be secured to the socket support 502 to retain the ratchet 512 in the recess 510.
  • the retaining plate 524 is secured to the socket support by screws (not shown) extending through bores 526 ( Figure 14) in the socket support 502 and into threaded blind bores 528 ( Figure 16) in the retaining plate 524.
  • the retaining plate 524 defines a frusto- conical or tapered outer surface 538 which advantageously permits the plate 524 to be readily removed when the apparatus 500 is secured to a prosthetic socket (not shown).
  • the retaining plate 524 shown from above, defines a central aperture 540 adapted to permit the ratchet pin 514 to pass therethrough to engage the ratchet 512.
  • the upper surface 542 of the retaining plate 524 is concaved which advantageously guides the ratchet pin 514 towards the aperture 540 upon fitting of the apparatus 500 of the present invention in conjunction with a prosthesis.
  • the apparatus 500 is shown fully assembled in Figure 18 of the drawings.
  • a prosthetic socket (not shown) is secured to the surface 506 of the socket support 502.
  • the pin 514 is threadably coupled to the base of a silicone sock (not shown) via upper thread 516.
  • the patient's residual limp with the silicone sock is then inserted into the prosthetic socket, until the pin engages the ratchet 512 ( Figure 13).
  • both the prosthetic socket and the patient's residual limb become secured to the apparatus 500.
  • the socket support 502 of apparatus 500 is shown in Figure 19 secured to a prosthetic socket 544.
  • the prosthetic socket 544 is moulded around the support surface 506 of the socket support 502.
  • the entire alignment apparatus 500 is shown secured to the prosthetic socket 544 in Figure 20.
  • the apparatus 500 defines a very low profile which advantageously permits proper alignment and securing of parts of a prosthesis where minimal space is available.
  • the apparatus of the present invention provides a number of advantages over prior art systems.
  • the apparatus of the present invention provides a compact component which may be located or used with prosthesis with severe space restrictions, such as in ankle disarticulation prosthesis.
  • the apparatus of the present invention allows ease of access to all adjusting points.
  • the apparatus may remain in place once a suitable alignment has been achieved, simplifying the fitting procedure and reducing the possibility of losing accuracy in the preferred alignment.
  • the embodiments described herein are merely exemplary of the present invention and it should be appreciated that the skilled person may conceive of various modifications and adaptations to the disclosed embodiments, while remaining within the scope of the present invention.
  • the ranges of adjustment may be altered in accordance with, for example, the size of the prosthesis being fitted, and thus the size of the apparatus; for example, a smaller range of alignment will conventionally be available on an apparatus to be used with a prosthesis to be fitted to a child.
  • the lugs 122 of the socket support 104 may include slots or the like in replace of or in addition to the two holes for receiving screws to secure the prosthetic socket to the socket support 104.
  • the apparatus may be utilised in conjunction with various suspension systems, including magnetic based systems.
  • the adjusting apparatus may include components adapted to be secured together, aligned, tilted or the like by magnetic fittings or connections.

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L’invention concerne un appareil d'alignement prosthétique (100) destiné à être utilisé pour aligner et joindre les parties d'une prothèse ayant une portion d'articulation et une portion de membre prosthétique comprenant un support de membre prosthétique (102), un support d'articulation prosthétique (104) et un ensemble de réglage (106) adapté pour être accouplé entre les supports de membre et d'articulation. L'appareil permet au membre prosthétique d’être translaté et incliné par rapport à la portion d'articulation pour réaliser l’alignement nécessaire. Une fois l'alignement correct obtenu, celui-ci peut être maintenu par l'ensemble de réglage de sorte que l'appareil d'alignement peut rester in situ.
PCT/GB2006/001149 2005-03-30 2006-03-29 Appareil d'alignement prosthétique Ceased WO2006103430A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0506352.4 2005-03-30
GBGB0506352.4A GB0506352D0 (en) 2005-03-30 2005-03-30 Prosthetic alignment device

Publications (1)

Publication Number Publication Date
WO2006103430A1 true WO2006103430A1 (fr) 2006-10-05

Family

ID=34566629

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2006/001149 Ceased WO2006103430A1 (fr) 2005-03-30 2006-03-29 Appareil d'alignement prosthétique

Country Status (2)

Country Link
GB (1) GB0506352D0 (fr)
WO (1) WO2006103430A1 (fr)

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102012013481A1 (de) 2012-07-09 2014-05-08 Otto Bock Healthcare Gmbh Vorrichtung zum Ausrichten eines Prothesenkniegelenkes
US8845755B2 (en) 2011-04-08 2014-09-30 Ifit Prosthetics, Llc Modular prosthetic devices and prosthesis system
FR3037497A1 (fr) * 2015-06-18 2016-12-23 Chabloz Composants Piece de jonction entre une emboiture prothetique et un membre prothetique.
US10398577B2 (en) 2011-04-08 2019-09-03 Ifit Prosthetics, Llc Modular prosthetic devices and prosthesis systems
US10806608B2 (en) 2011-04-08 2020-10-20 Ifit Prosthetics, Llc Prosthetic method and apparatus
US11382775B2 (en) 2011-04-08 2022-07-12 Ifit Prosthetics, Llc Modular prosthetic devices and prosthesis systems

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5888233A (en) * 1996-04-26 1999-03-30 Centri Ab Arrangement for leg prosthesis
US6013105A (en) * 1998-03-10 2000-01-11 Model & Instrument Development Corporation Prosthesis connector and alignment assembly
US6051026A (en) * 1997-05-05 2000-04-18 Biedermann Motech Gmbh Alignment device for connecting a stump socket to a prosthetic limb
US6398817B1 (en) * 1997-09-26 2002-06-04 Centri Ab Locking device for a prothesis

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5888233A (en) * 1996-04-26 1999-03-30 Centri Ab Arrangement for leg prosthesis
US6051026A (en) * 1997-05-05 2000-04-18 Biedermann Motech Gmbh Alignment device for connecting a stump socket to a prosthetic limb
US6398817B1 (en) * 1997-09-26 2002-06-04 Centri Ab Locking device for a prothesis
US6013105A (en) * 1998-03-10 2000-01-11 Model & Instrument Development Corporation Prosthesis connector and alignment assembly

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8845755B2 (en) 2011-04-08 2014-09-30 Ifit Prosthetics, Llc Modular prosthetic devices and prosthesis system
US10398577B2 (en) 2011-04-08 2019-09-03 Ifit Prosthetics, Llc Modular prosthetic devices and prosthesis systems
US10806608B2 (en) 2011-04-08 2020-10-20 Ifit Prosthetics, Llc Prosthetic method and apparatus
US11382775B2 (en) 2011-04-08 2022-07-12 Ifit Prosthetics, Llc Modular prosthetic devices and prosthesis systems
DE102012013481A1 (de) 2012-07-09 2014-05-08 Otto Bock Healthcare Gmbh Vorrichtung zum Ausrichten eines Prothesenkniegelenkes
DE102012013481B4 (de) 2012-07-09 2019-05-02 Ottobock Se & Co. Kgaa Vorrichtung zum Ausrichten eines Prothesenkniegelenkes
FR3037497A1 (fr) * 2015-06-18 2016-12-23 Chabloz Composants Piece de jonction entre une emboiture prothetique et un membre prothetique.

Also Published As

Publication number Publication date
GB0506352D0 (en) 2005-05-04

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