Abstract
The invention relates to an artificial knee joint comprising; an upper part (10) and a lower part (20) which are mounted on one another such that they can pivot about a pivot axis (12); a hydraulic resistance device (30) between the upper part (10) and the lower part (20), which resistance device provides resistance to a pivoting movement, the resistance device (30) having a switching valve (50) in a hydraulic line (37), the switching valve (50) having a valve body which can be displaced in a displacement direction and, in a first position, blocks or partially closes the hydraulic line (37) and, in a second position, releases the hydraulic line (37) and is designed or positioned in such a manner that a pressure force component acting on the valve body (55) perpendicularly to the displacement direction through the hydraulic fluid generates a holding force that counteracts a displacement of the valve body (55), wherein an actuator (60) for exerting a release force is associated with the valve body (55) and moves the valve body (55) from the first to the second position, characterized in that the actuator (60) is coupled to a control device (70) which is connected to a sensor for detecting state data and activates the actuator (60) on the basis of the state data, and the release force is set to be less than the holding force at a predefined pressure force.
Claims
1. An artificial knee joint, comprising: an upper part; and a lower part, wherein the upper part and the lower part are mounted on one another so that they are pivotable about a pivot axis; a hydraulic resistance device between the upper part and the lower part configured to provide a resistance to a pivoting movement; a switching valve in a hydraulic line of the hydraulic resistance device, wherein, the switching device comprises a valve body which is displaceable in a displacement direction, wherein the switching valve blocks or partially closes the hydraulic line in a first setting and releases the hydraulic line in a second setting, and wherein the switching valve is configured or arranged such that a pressure force component acting on a valve body of the switching valve perpendicularly to the displacement direction as a result of hydraulic fluid generates a holding force which opposes a displacement of the valve body; an actuator configured for exerting a release force which moves the valve body out of the first setting and into the second setting is assigned to the valve body, wherein the actuator is coupled or coupleable to a control device which is connected to a sensor for recording status data, wherein the control device activates the actuator based on the status data, and wherein the release force is adjusted to be less than the holding force for a predefined pressure force.
2. The artificial knee joint as claimed in claim 1, wherein the actuator is configured as a motor or electromagnet.
3. The artificial knee joint as claimed in claim 1 wherein the valve body is assigned an energy storage mechanism and/or a magnet which opposes the release force.
4. The artificial knee joint as claimed in claim 3, wherein the energy storage mechanism is a spring element/energy storage mechanism that is configured to be adaptable/adjustable.
5. The artificial knee joint as claimed in claim 1 wherein the release force that can be applied by the actuator is adjustable.
6. The artificial knee joint as claimed in claim 1 further comprising a gearing, a lever mechanism, or a link rod combination, is arranged between the actuator and the valve body.
7. The artificial knee joint as claimed in claim 1 wherein the hydraulic resistance device comprises a hydraulic chamber with a piston arranged therein, wherein the piston subdivides the hydraulic chamber into an extension chamber and a flexion chamber which are in fluidic communication with one another via the hydraulic line, wherein at least one of the extension chamber and the flexion chamber is or are assigned at least one nonreturn valve with at least one throttle valve connected in parallel with the at least one nonreturn valve.
8. The artificial knee joint as claimed in claim 7, wherein the switching valve is connected in parallel with the at least one throttle valve.
9. The artificial knee joint as claimed in claim 7 wherein the at least one nonreturn valve includes at least two nonreturn valves, and wherein each of the extension chamber and the flexion chamber is assigned a nonreturn valve of the at least two nonreturn valves, and wherein and the at least two nonreturn valves are arranged acting in opposition.
10. The artificial knee joint as claimed in claim 7 further comprising at least one for recording a flow direction and/or for recording pressure.
11. The artificial knee joint as claimed in claim 7 further comprising a further throttle valve is connected fluidically upstream or downstream of the switching valve.
12. The artificial knee joint as claimed in claim 7 wherein the at least one throttle valve is adjustable.
13. The artificial knee joint as claimed in claim 7 wherein the at least one nonreturn valve comprises a first nonreturn valve and a second nonreturn valve, and wherein the at least one throttle valve is assigned the a second nonreturn valve connected in parallel with the first nonreturn valve, wherein the second nonreturn valve is connected upstream or downstream of the at least one throttle valve in the flow direction, and wherein the second nonreturn valve acts in opposition to the first nonreturn valve, and is assigned a status sensor.
14. The artificial knee joint as claimed in claim 7 further comprising at least one relief valve is arranged in the piston, wherein the at least on relief valve is arranged in a connecting channel that connects the flexion chamber to the extension chamber.
15. The artificial knee joint as claimed in claim 7 wherein the at least one nonreturn valve is assigned a sensor for status recording of the at least one nonreturn valve.
16. A method for controlling an artificial knee joint as claimed in claim 1, comprising: varying resistance as a function of a spatial orientation of the lower part and/or of the upper part, wherein the spatial orientation includes a spatial angle and is determined during use of the artificial knee joint by an inertial angle sensor, wherein the spatial angle determined is compared with at least one threshold value; and activating or deactivating the actuator when the threshold value is reached or exceeded.
17. A method for controlling an artificial knee joint as claimed in claim 1, comprising: varying resistance a function of changes in a spatial orientation of the lower part and/or of the upper part, wherein the spatial orientation is determined during use of the artificial knee joint by an inertial angle sensor, wherein a rate of change of the spatial orientation determined is compared with at least one threshold value; and activation or deactivating the actuator when the threshold value is reached or exceeded.
18. The method as claimed in claim 17, wherein, because of the fluid properties of the switching valve, a flexion of an artificial knee joint initiated after activation of the actuator can be performed unimpeded until the natural movement reversal of the knee joint.
19. The method as claimed in claim 17, wherein, because of the properties of the switching valve, after activation of the actuator, the flexion of an artificial knee joint can only be initiated if the bending moment at the time of activation of the actuator does not exceed a defined threshold value.
20. The method as claimed in claim 19, wherein the threshold value is negative, which corresponds to an extension moment at the artificial knee joint.
Description
[0022] FIG. 1shows a schematic representation of an artificial knee joint with a resistance device;
[0023] FIG. 1ashows a variant of FIG. 1;
[0024] FIG. 2shows a hydraulic circuit diagram of the resistance device;
[0025] FIG. 2ashows a variant with rotational hydraulics;
[0026] FIG. 3 to FIG. 5show variants of FIG. 2;
[0027] FIG. 6shows a detail representation of the hydraulic line with a switching valve;
[0028] FIG. 7shows two states of the switching valve and its design structure;
[0029] FIG. 8shows a schematic representation of a linear resistance device with a rotary actuator;
[0030] FIG. 9shows a schematic representation of a rotational resistance device with a linear actuator.
[0031] FIGS. 1 and 1a show a schematic representation of an artificial knee joint, as part of a prosthesis in FIG. 1 or an orthosis in FIG. 1a. The artificial knee joint comprises an upper part 10 and a lower part 20, which are mounted on one another so that they can pivot about a pivot axis 12. In an embodiment as the prosthesis according to FIG. 1, a prosthetic foot is arranged on the lower part 20 at the distal end, and in the embodiment of the artificial knee joint as an orthotic knee joint according to FIG. 1a, the lower part 20 may be configured as a lower leg rod, on which a foot part does not need to be arranged. For the case of a KAFO, a foot part on which a foot can be placed is arranged on the lower part 20, as shown. In one embodiment of an orthosis, the upper part 10 is fastened on an upper leg by means of fastening elements 10a and the lower part 20 is fastened on the lower leg by means of fastening elements 20a. The fastening elements 10a, 20a are used for repeated detachable fastening the orthosis on the leg, or the limb. The fastening elements 10a, 20a may be configured as belts, shells, clasps, clips or similar devices in order to fix the orthotic components on the limb in question.
[0032] Arranged between the upper part 10 and the lower part 20 there is a resistance device 30 as a linearly acting resistance device 30. In the exemplary embodiment shown, the resistance device 30 is configured as a hydraulic resistance device with a hydraulic chamber 35. The hydraulic chamber 35 is arranged or formed in a housing, and forms a cylinder in which a piston 34 is movably mounted. The piston 34 is movable along the longitudinal extent of the cylinder or of the hydraulic chamber 35, and is fastened on a piston rod 34 which protrudes from the housing or base body with the hydraulic chamber 35 arranged therein. The piston 34 subdivides the hydraulic chambers 35 into an extension chamber 31 and a flexion chamber 32, which are in fluidic communication with one another via the hydraulic line, as will be explained later. The base body or the housing with the hydraulic chamber 35 may be mounted on the lower part 20 so that it can turn, in order to prevent tilting of the piston 34 during a turning movement of the upper part 10 relative to the lower part 20. The end of the piston rod 33 remote from the piston 34 is fastened on the upper part 10, in the exemplary embodiment shown on an bracket in order to increase the distance from the pivot axis 12. During a flexion, the piston 34 is pressed downward so that the flexion chamber 32 is reduced and correspondingly the volume of the extension chamber 31 is increased less the volume of the piston rod 33 being inserted. The differential volume resulting from the piston rod is balanced by a compensating volume (not shown). Because of the flow resistance inside the hydraulic line shown between the extension chamber 31 and the flexion chamber 32, a resistance opposes a flexion movement. The resistance is adjustable. Different volume changes in the extension chamber 31 or flexion chamber 32 are respectively compensated for by means of a compensating volume 38.
[0033] In the exemplary embodiment shown, both on the upper part 10 and on the lower part 20 there is arranged a sensor 40 for recording the spatial orientation of the lower part 20 or respectively of the upper part 10. By means of this sensor 40, which may for example be configured as an IMU, the spatial angle or the absolute angle with respect to a fixed spatial orientation, for example the direction of gravity, is determined during use of the artificial knee joint. Instead of an IMU, the sensor 40 may also record other status data, in particular status data that relate to the artificial knee joint. In particular, positions, angular settings, speeds, accelerations, forces and profiles or changes thereof are recorded as status data. The spatial angle determined for the upper part 10 and/or the lower part 20 or another status variable is compared with a threshold angle. When a threshold value that is stored in a control for the respective sensor value or a quantity derived therefrom is reached or exceeded, an actuator is activated or deactivated in order to vary the flow resistance in the resistance device 30.
[0034] Alternatively or in addition, a sensor 45 for measuring the knee angle and/or the knee angular velocity may be provided, the information of which may be used in particular to influence the behavior of the resistance device 30 during the swing phase.
[0035] The resistance device 30 in an artificial knee joint is used to moderate a flexion movement and an extension movement in order to generate or assist a suitable or desired movement sequence. An extension movement is advantageously braked shortly before reaching a maximum extension, in order to avoid a hard stop. A flexion movement is braked or suppressed in the stance phase and in the swing phase in order to ensure limitation of the bending. Particularly in the stance phase, it is necessary to avoid an erroneous reduction of the flexion resistance after a heel strike in the so-called stance phase flexion. If the artificial knee joint is in a bent setting, for example, and continues to be loaded in the flexion direction, an unintended or undesired reduction of the flexion resistance may lead to unintended bending of the artificial knee joint. In order to achieve reliable use of the artificial knee joint, arranged in the resistance device 30 there is a hydraulic circuit which, by means of mechanical and electronic components, ensures that there is no unintended reduction of a flexion resistance or else of an extension resistance.
[0036] FIG. 2 shows the general principle of the hydraulic circuit inside the resistance device 30. The piston rod 33 protrudes from the hydraulic chamber 35 and is directly or indirectly fastened either on the upper part 10 or on the lower part 20 of the artificial knee joint. The hydraulic chamber 35 is then respectively secured on the other part of the artificial knee joint or coupled thereto. It can be seen from FIG. 2 that two relief valves 36 are arranged inside the piston 34 in the connecting channels 341 between the extension chamber 31 and the flexion chamber 32. The two relief valves 36 are arranged acting in opposition in order in the event of an overload not to destroy any mechanical components, but rather to allow yielding against a spring resistance of the relief valves 36. Arranged between the extension chamber 31 and the flexion chamber 32 there is also a hydraulic line 37 through which the hydraulic fluid flows during a movement of the piston 34 when the relief valves are closed. A compensating container 38 is used as a storage container in order to compensate for the volume change due to the insertion or retraction of the piston rod 33. In the exemplary embodiment shown, arranged in the hydraulic line 37 are two nonreturn valves 52, which are oriented acting in opposition. Adjustable throttle valves 51, by means of which the flexion resistance or extension resistance can be adjusted during a flexion movement or extension movement, respectively, are arranged in parallel with the nonreturn valves 52, which may also be spring-loaded. The adjustment may be permanent, or take place once, or it may be varied. In order to achieve a variable throttle effect, the throttle valves 51 are assigned controlling devices which are actuated on the basis of sensor values and/or by means of mechanical force transmission, so that the respective flow resistance in the respective flow direction can be adjusted as a function of sensor values or loads, or settings, in an orthopedic joint device. A switching valve 50 is arranged at the outlet of the flexion chamber 32 in parallel both with a nonreturn valve 52 and with a controlling valve 51. The nonreturn valve 52 at the exit of the flexion chamber 32 locks the fluid flow from the flexion chamber 32 during a flexion movement so that hydraulic fluid from the flexion chamber 32 must flow through the throttle valve 51 and/or the switching valve 50 on the way into the extension chamber 31. In the exemplary embodiment shown, a throttle valve 51 is additionally connected downstream of the switching valve 50 in the flow direction. The switching valve 50 is thus connected to an actuator (not shown), which is in turn activated or deactivated by means of a control device 70. The control device 70 is coupled to one or more outer sensors 40 for recording status data, and activates or deactivate the actuator in order to open or close the switching valve 50. Besides the external sensors 40, status sensors 41 of the nonreturn valves 52 are optionally coupled to the control device 70. The status sensors 41 in their simplest embodiment are configured as switches and detect whether the respective nonreturn valve 52 is opened or closed. If the nonreturn valve 52 assigned to the switching valve 50 is in a closed state in order to lock the fluid flow during a flexion movement, it can be detected thereby which movement or which load is applied to the artificial knee joint. If this nonreturn valve 52 is in an opened setting, it can be seen thereby that no moment that would cause a flexion movement is acting about the pivot axis 12. This is essential input information for the control device 70.
[0037] FIG. 2a shows a variant of FIG. 2 with rotational hydraulics. The hydraulic circuit connecting the extension chamber 31 to the flexion chamber 32 corresponds to the circuit according to FIG. 2. Instead of a linearly acting piston, a rotary piston 34 that separates the extension chamber 31 from the flexion chamber 32 is arranged inside the hydraulic chamber 35. The compensating container 38 is used to compensate for fluid losses and thermally induced changes of the oil volume. The compensating container 38 is not necessary in order to compensate for different volumes due to a piston rod being inserted or retracted since the latter is absent in rotational hydraulics. The compensation volume therefore becomes comparatively small in the case of rotational hydraulics compared with linear hydraulics.
[0038] FIG. 3 shows a variant of the embodiment according to FIG. 2 in which there is essentially the same structure but the control device 70 is not equipped with sensors 41 for recording the flow direction, or for finding the status of the nonreturn valves 52. Rather, with a substantially unmodified mechanical structure, simplified control is provided merely on the basis of status data by means of the sensors 40, for example by means of an IMU and exclusively only an IMU. The switching valve 50 is configured in such a way that a release force exerted by the actuator in order to enable the flow channel does not exceed an adjusted setpoint value. The setpoint value is ascertained by the fact that, with a predefined pressure force, a valve body inside the switching valve 50 requires a predefined release force, that is to say a resistance opposes an adaptation from a closed state into an opened state. If a knee joint is loaded with a force or a moment that acts in the flexion direction, a pressure force due to the hydraulic pressure from the flexion chamber is applied both to the throttle valve 51 connected in parallel and to the switching valve 50. The nonreturn valve 52 likewise connected in parallel at the flexion chamber outlet is closed. If in such a state the control device 70 receives from a sensor device 40 a sensor value which, after evaluation, leads to a control instruction that brings about activation of the actuator, a corresponding signal is output to the actuator and a release force is exerted on the valve body. If the holding force opposing the release force due to the applied pressure is too great, the switching valve 50 cannot open so that erroneous initiation in the event of a knee joint loaded in the flexion direction is prevented.
[0039] The switching valve 50 may be designed so that, after activation once by the control device 70, it remains open until the flow of fluid through the valve falls below a threshold value. Unimpeded flexion of the knee joint may therefore be achieved, but the knee joint device automatically returns into the highly damped, safe state as soon as the movement is ended or the movement direction is reversed.
[0040] FIG. 3a shows the minimum equipment of a resistance device with the hydraulic chamber 35 and the piston 34 arranged therein in order to form an extension chamber 31 and a flexion chamber 32. Alternatively to a configuration as linear hydraulics, it may also be configured as rotational hydraulics according to FIG. 2a. The hydraulic line 37 connects the extension chamber 31 to the flexion chamber 32 and the compensating volume 38. Before a connection of the hydraulic line 37 to the flexion chamber 32 there are a nonreturn valve 52 and a switching valve connected in parallel therewith. The switching valve 50 is adapted by means of the control device 70, which is in turn coupled to the sensor device 40. The nonreturn valve locks the outflow from the flexion chamber 32 in the direction of the extension chamber 31 and still enables the flow from the extension chamber 31 into the flexion chamber 32. It is therefore possible that extension can always take place, but flexion can only take place if the switching valve 50 is correspondingly opened.
[0041] In FIG. 4 there is a similar hydraulic structure as in FIGS. 2 and 3, but the extension chamber 31 is assigned at the exit a further nonreturn valve 52, which is in turn assigned a status sensor 41 for recording the flow direction. Two nonreturn valves 52 connected in opposition are therefore arranged at the exit of the extension chamber. If an extension movement takes place, the status sensor 41 detects an opened nonreturn valve and can thereby determine the movement direction and the loading direction in the artificial knee joint. In the case of a flexion movement, the closed state of the nonreturn valve 52 provided with the status sensor 41 can be detected. If in this structure the switching valve 50 is opened and furthermore a hydraulic flow is possible through the throttle valve or throttle valves 51, then a return flow into the extension chamber 31 is also possible.
[0042] Shown in FIG. 5 is a variant of the hydraulic structure of the resistance device in which a flow-direction, flow-rate or flow sensor 41, which is coupled to the control device 70, is arranged in the hydraulic line 70 from the extension chamber 31 to the flexion chamber 32. A pressure sensor 41a, which is optional, is arranged between the switching valve 50, the throttle valve 51 and the single nonreturn valve 52 in parallel with the two aforementioned valves 50, 51, in order to ensure that no bending load, force or moment is applied to the knee joint in the flexion direction. The pressure sensor 41a may be constructed simply, since only a binary or digital status signal is necessary, so that the pressure sensor 41a may also be configured as a pressure switch that is activated by a piston or a membrane when a sufficiently high hydraulic pressure from the flexion chamber 52 is applied in the hydraulic line 37. The direction sensor 41 for identifying the flow direction or pressure direction of the hydraulic fluid may have a different design, for example as a nonreturn valve with status recording, as a turbine wheel with rotation direction recording, as a gauge sensor, as a light beam sensor, by means of magnets, or the like. The throttle valve 51 in parallel with the switching valve 50 is generally a valve with a high throttle effect, which is used for example for stance phase flexion damping. The throttle valve 51 shown in FIGS. 2 to 4, which is assigned to the flexion chamber 32, is used for extension damping in the case of a flow of the hydraulic fluid from the flexion chamber 32 back into the extension chamber 31, and has a comparatively low throttle effect which may also be adapted as a function of the position of the piston 34. The throttle valve arranged in the flow direction from the flexion chamber 32 into the extension chamber 31, behind the switching valve 50 in the flow direction, is used for flexion damping in the swing phase and is an optional valve, which has a comparatively low throttle effect that may likewise be adapted as a function of the position of the piston 34.
[0043] FIG. 6 schematically shows a more detailed representation of the switching valve 50 and an actuator 60. The hydraulic structure is indicated only incompletely, a return line from the flexion chamber 32 to the extension chamber 31, as well as a compensating container, being omitted. In the state shown, the switching valve 50 is closed, i.e. fluid from the flexion chamber 32 cannot flow through the switching valve 50. It has to pass through the throttle valve 51 connected in parallel with a very high throttle effect in order to reach the extension chamber 31. The switching valve 50 is assigned an actuator 60, which is configured as a motor, electromagnet, solenoid or other switching device or actuation device, in order to be activated on the basis of sensor values by means of the control device 70 (not shown). In the exemplary embodiment shown, the actuator 60 acts against an energy storage mechanism 56, for example a spring, an elastomer element or a magnet. If the actuator 60 is not activated, the switching valve 50 is closed. In order to open the switching valve 50 and reduce the flexion resistance, the actuator 60 is activated and a force is applied sufficiently to move an unloaded switching valve 50 from the closed setting shown into an opened setting, or release setting, when there is no pressure force component acting on a valve body due to an applied hydraulic pressure. If however a pressure is applied to the valve body of the switching valve 50 because of a force (which is indicated by an arrow) acting on the piston rod, a holding force is thereby generated, for example by the pressing of the valve body into its guide, so that the release force applied by the actuator 60 is not sufficient to move the valve body from the closed setting into the release setting. The throttle valve 51 optionally connected in series with the switching valve has a rather low throttle effect and is used to adjust the swing phase damping.
[0044] FIG. 7 shows the schematic structure of the switching valve with the valve body 55 inside a valve housing with the drive 60 and the spring element 56. In the representation on the left, the hydraulic flow inside a hydraulic line is blocked. The valve body 55 is located in a housing in which the hydraulic line 37 is arranged or formed. The valve body 55 is assigned via the actuator 60 in the form of a solenoid or a magnet coil, inside the coil there is a magnet that is coupled to a pin which in turn acts on the valve body 55. If a current flows through the coil, the magnet moves upward inside the coil and the pin presses on the valve body 55 against the spring force that is applied by the energy storage mechanism 56 and holds the valve body 55 in the first, closed setting. This state is shown in the representation on the right. The hydraulic line 37 is fully opened and allows the hydraulic fluid to flow through. The mechanical interaction between the valve body and the housing is configured so that, when a hydraulic pressure is applied from the flexion chamber in the direction of the extension chamber, friction or engagement of projections and recesses takes place so that an increased displacement force is necessary in order to move the valve body 55 into the opened setting. This pressure force is sufficient to increase the required release force beyond an amount such that the necessary force cannot be applied by the actuator 60. Thus, if a hydraulic pressure is applied to the valve body 55, the actuator 60 cannot move the valve body 55 into the second, opened setting against the spring force of the energy storage mechanism 56 in combination with a holding force by the mechanical mounting or a corresponding configuration of the incident flow surface of the valve body 55. The housing, or the housing and the valve body 55, is/are advantageously configured so that a high release force, which has to be applied by the actuator 60, is necessary in the event of a high pressure.
[0045] With the mechanical design of the resistance device 30 in combination with the control concept of the control device 50, it is possible to make do with a minimum of sensor signals for controlling a flexion release and/or an extension release. This may for example via a single spatial attitude sensor 40 or an IMU information relating to a swing phase release be sent to the control device 70, by means of which an actuation of the actuator 60 and a subsequent release of the switching valve 50 would normally take place. If however a sufficiently large pressure force component is applied perpendicularly to the displacement direction of the valve body 55, for example because of an unforeseen flexion load, the necessary release force is increased due to the mechanical design so that the release cannot take place. Only when the pressure force from the flexion chamber 32 abates can the switching valve 50 be opened, so that the bypass for the conventional throttle valve 51 is opened and the hydraulic resistance is reduced. In the return circuits mentioned above, an extension movement is always possibly because of the nonreturn valves. In principle, it is therefore possible to enable reliable and in particular safe control of an artificial knee joint exclusively with an IMU. In particular, unintended initiation of a flexion movement is avoided.
[0046] FIG. 8 shows the linking of a switching valve to a lever gearing via a rotational drive 60. The rotary drive 60, or rotational drive, may be configured as a motor or as a rotary component of a gearing device connected downstream of a motor. By means of a lever 90, which is mounted or fastened so that it can pivot both on the rotary drive 60 and on the linear switching valve 50, the adaptation of the valve 50 can be brought about in the manner of a connecting rod.
[0047] Alternatively, a linearly actuated switching valve may also be actuated directly by means of a linear drive. Transformation may in this case be produced by means of an optional lever mechanism.
[0048] FIG. 9 shows the kinematic reverse of FIG. 8, in which there is a linear drive 60 that is coupled by means of a lever 90 corresponding to the arrangement of FIG. 8 to a switching valve 50 configured as a rotary valve. The respective flow direction and incident flow of the hydraulic fluid are represented by the arrows.
[0049] Alternatively, a switching valve configured as a rotary valve may also be actuated by means of a rotational actuator. Besides a direct drive, the actuation may also take place via gearing with suitable transformation, a link rod mechanism or a combination of these components.
