novel design of an anterior cruciate ligament (acl) injury prevention brace rachel porter dan...
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1
Novel Design of an Anterior Cruciate Ligament (ACL) Injury Prevention Brace
Rachel Porter
Dan Greenshields
Justin Killewald
Lawrence Technological UniversityBME Senior Projects 1Dr. Mansoor Nasir, Fall 2013
Faculty Advisor: Dr. Eric Meyer, PhDTechnical Advisor: Ken Cook, P.E.
2Agenda
Problem
Need Statement
Background
Knee Anatomy
Knee Mechanics
Knee Injuries
ACL Injuries
ACL Injury Mechanisms
Objective
Current progress/Future plans
Research plan
Design Process
Patent
Testing
Cost & materials
Timeline
Tasks & responsibilities
3Problem
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
4Need 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
5Design
ACL braces
Prevent hyperextension
Prevent valgus bending
Osteoarthritis braces
Unicompartmental loading
Include design characteristics of prevention braces
6Knee Anatomy
Bones
Ligaments
Menisci
Cartilage
Muscles/tendons
[2] http://www.webmd.com/pain-management/knee-pain/picture-of-the-knee
7Knee Motions
Sagittal
Flexion
Extension
Coronal/Frontal
Valgus bending
Varus bending
Axial Internal rotation
External rotation
8Knee Injuries Bone fracture
Torn ligament
ACL
PCL
MCL
LCL
Torn meniscus
Lateral
Medial
Osteoarthritis
[7]
9ACL 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
10ACL Injury Mechanisms
Internal rotation
Foot planted as body twists
Anterior shear of tibia
Foot planted as knee is hit from the front
Axial Load
Compressive force causes tibial slipping (5500 N) [4]
Hyperextension
Tension on ACL causes tearing
Valgus bending
Knee is angled towards center of body
11Objective
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
12Current 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
13Osteoarthritis 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
14Modified 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
15Modified Hinge Design cont.
Polycentric normal action Compressive loading – flexed action
16Patent Filing Process
http://www.uspto.gov/patents/process/index.jsp
17Current Patent Search
Hundreds of knee brace patents
OA brace
ACL brace
Individual components patented
Hinge - consistent
Strap
Frame
18Future 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
19Institutional 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
http://www.irbservices.com/irbservices/Choose_IRBS_files/IRBS%20Master%20Logo.png
20Current Testing Techniques
3D motion capture
20 participants
Stop-jump landings
With and without brace
Measured
Knee flexion angle
Ground reaction forces
[5]
21Experimental 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
22Cost & Materials
Braces = $1000
Donjoy OA Defiance Brace
1 male and 1 female
Hinge redesign material = $500
Springs, screws, washers, stainless steel
Testing supplies = $300
Velcro, double sided tape
LESA foundation - $1000 granted
23Timeline
Month Milestone
January Assemble first prototype brace and begin human subject testing
February Continue testing prototype and adjust design
March Adjust design and continue testingData analysis
April Data analysis and interpretation
May Prepare final report and presentationFile provisional patent
24Anticipated Challenges
Not a significant decrease in compressive load forces
Time restrictions
Failed IRB approval
Patent filing
25Tasks & Responsibilities
Individual tasks
Rachel Porter
Institutional Review Board (IRB) filing
Dan Greenshields
Existing knee brace patent search
Patent application
Justin Killewald
Hinge design research
Materials used in braces
Shared tasks
Prototype design & fabrication
Testing
Data analysis
Presentation creation
Final report documentation
26References
[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.
27Questions?