functional knee brace for oa &...
TRANSCRIPT
Liganment, Meniscus, Cartilage, Muscle, Alignment
Functional Knee Brace forOA & Instability
Dr. Cheng Ngok, Orthopaedic Surgeon
(Rubber)(Rubber)
180°: Relaxed90°: Tight
180°:Tight90°:Relaxed
Meniscus (Outer:Thick, Inner:Thin) Tibial plateau
Meniscus Medial
ACL
Lateral
Meniscus
LCL
MCL
Tibial plateau
Tibial plateau
Tibial liganment
②
③
①
Using 3-points leverage to
transfer the weight bearing
to normal size, so the
affected side will not come
apart and will regeneration.
(Choice of meniscus tear’s treatment)
Feel weight-bearing at medial size
Meniscus tear atRed zone
Meniscus move forward
when knee extension
Meniscus move backward
when knee flexionMeniscus follow
knee rotation
Ring pressure on the meniscus:
Disperses body pressure
After meniscus injury:
Ring pressure disappears, upper body pressure
is concentrated on the tibial plateau
Quadriceps
Hamstrings
Knee:Front view
Knee:Back view
Pain Pain
Normal
Loading
alignment
Inspection alignment: Judgment of
foot type and pain point
Anatomical
line
1. Isolated Tear: ACL(4*), PCL(*), MCL(2*), LCL(*)
2. Multiple Tear:
(a) ACL + MCL ± medial meniscal tear
(b) ACL + LCL ± lateral meniscal tear
后十字韧带
Movement of knee instability
Tibial plateau
Meniscus Medial
ACL
Lateral
Meniscus
LCL
MCL
Tibial plateau
Tibial plateau
Tibial liganment
PCL
Torn LPCL
Triad
ACL partial tear
1. Old knee injury
2. Risky sports or work
3. Weak knee muscles (Ladies)
Hard plastic bar:
Prevents MCL /
LCL tear.
Double upright
hinge with
extension /
flexion control.
Soft plastic
frame. Prevents
ACL / PCL. tear
Functions:
(Knee general artificial joint)
Complete ACL tear
K07b ACL Light Brace
± 40y
± 10y
± 20y
Future
Option1:Casting
Option4:Free of brace or cast
Option2:Post-op Knee Brace K19b
Option3:ACL Light Brace K07b
Reasons (rationale) of Post-OP using ROM brace ?
②
③
①
Unbraced OA of a 50-year old metal worker
Before
Correction
During
Correction
Braced by OA corrector of the same metal worker
3-points leverage
• Stabilize the joint
• Realign malalignment
• Prevention of OA
• Relieve loading Pain
Malalignment
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Draper[1] Horlick[2] Matsuno[3] Pollo[4]
No Sedan Chair No CrutchNo Wheelchair
±80y±60y
>100y
±20y
Improvement of life quality Surgery free or delay surgery
• Walking Pain Free
• Non-drugs
❖Not suitable for overweight patients
❖Not suitable for swollen knee
❖Not suitable for serious OA
❖Not suitable for psychosis patients
❖Patients need cooperation, clinical follow-up