The LVATE brace as a tool to delay total knee replacement surgery for patients with knee arthritis

Abstract

During the course of this thesis, the design of a knee brace that improves the quality of life for people with arthritis in the knee, is being researched. The knee joint is covered with articular cartilage which protects the bones from being damaged. Arthritis of the knee is a pathology where this cartilage is damaged potentially even to the extent that direct bone-to-bone contact occurs. The most common symptoms for the patient are pain and inflammation, affecting their mobility and quality of life. Firstly, research is conducted on the arthritis knee disorder, the patients and their interests, and the technical aspect of a knee brace in relation with the knee kinematics. The following main insights are revealed by the analyses: -Arthritis in the knee is wear and tear of the articular cartilage caused by loading. This can be the result of extensive sports, overweight, incorrect alignment of the joint or aging. -There are no treatments available that cure the damaged cartilage tissue. It is in the patient’s interest to slow down the deterioration process. When the disorder impacts the quality of life too much, replacement surgery can be opted for. -Replacement surgery is the last resort option due to its invasiveness, possible complications and high rate of dissatisfied patients. It is therefore preferred to delay the need for a surgery if possible. -The deterioration process can be slowed down by exposing the knee joint to less load. Partially unloading the joint can be beneficial during demanding activities or even daily activities, depending on the stage of arthritis. -A customized fit of the knee brace is preferred for increased comfort and effectiveness. Secondly, during the development phase, two main challenges are explored, being the custom fit of the brace and the unloading mechanism. To make a perfectly fitting brace design, many mock-ups are created and evaluated on their comfort and secure fit. The insights are translated into a standard model that can be shaped around the patient’s 3D scan of the leg. This experimental approach is also applied to find an unloading mechanism that can be integrated in the brace. The concepts are tested by attaching them to the brace mock-ups that were created when exploring the perfect fit. Thirdly, a design proposal is created, resulting in the LVATE brace that can be integrated in Orthobroker’s product-service platform. During the patient’s appointment with an orthotist, a 3D scan of the leg is made and uploaded to a digital platform. The platform morphs the LVATE brace around the 3D scan in such a way that it distributes pressure among tolerant zones of the leg. The brace can then be ordered right away. The unloading mechanism is activated by rotating a knob that is positioned on the lateral side of the brace. Finally, the brace is evaluated on its feasibility, desirability and viability. A conclusion is derived from the evaluation feedback and recommendations are prepared for a further development of the design proposal.