WO2009017949A1

WO2009017949A1 - Hip orthosis with posterior extension for stabilizing the torso

Info

Publication number: WO2009017949A1
Application number: PCT/US2008/069686
Authority: WO
Inventors: Alan T. Sandifer; Shannon R. Schwenn
Original assignee: Orthomerica Products, Inc.
Priority date: 2007-07-31
Filing date: 2008-07-10
Publication date: 2009-02-05

Abstract

An improved hip orthosis is provided having a first body member and a second body member respectively conforming to portions of the user's hip and upper leg. A closure unit can be utilized to exert a retention force on the user's hips. An adjustable posterior spinal orthotic unit has a lower portion secured by the hip engaging unit and an upper thoracic extension member that can be adjustably set to the user's body length. Adjustable shoulder strap assemblies can provide forces to draw the user's spinal column to the cantilevered thoracic extension member. This provides improved anchoring of the hip engaging unit against undesirable movements of the user to stabilize the control of flexion/extension and abduction/adduction in stabilizing a compromised hip joint of a user.

Description

HIP ORTHOSIS WITH POSTERIOR EXTENSION FOR STABILIZING THE TORSO

BACKGROUND OF THE INVENTION

Related Applications

[0001] The present application is a continuation-in-part of PCT/US2007/074875 filed on 31 July 2007. This application also claims priority of U.S. Provisional Patent Application No. 61/041,148 filed March 31, 2008 and International Application No. PCT/US2007/074875 filed July 31, 2007.

1. Field of the Invention [0002]

The present invention is directed to a lightweight hip orthoses with enhanced control of flexion/extension and abduction/adduction by stabilizing the position of the hip orthoses on the patient through a posterior extension positioned along the patient's spinal column towards the patient's shoulders, more particularly the provision of a relatively flexible and adjustable posterior extension along the patient's spine increases the control of hip flexion/extension and abduction/adduction of a hip joint.

2. Description of Related Art [0003]

As the population ages, it has created a greater demand for orthotic management of any hip joint that has been compromised. Following a hip joint replacement, it is important to provide proper post-operative treatment of the patient after arthoplatyies.

[0004]

Orthotic management of hip joint compromise has been a challenge for orthopaedics, orthotists, and therapists when dealing with patients whose hip joints and their associated soft tissues, joint integrity, alignment, and bone and capsular components are compromised. A hip is a multidirectional joint capable of flexion, extension, internal and external rotation, adduction, and abduction. In addition to its mobility, the hip joint must absorb the force of full weight-bearing and provide stability to the pelvis both for standing and for single support during gait. Additionally, during walking, while one hip is stabilized, the opposite leg must have the strength, range of motion, and structural integrity to advance. [0005]

The hip joint is a synovial ball and socket joint that consists of the articulation of the spherical head of the femur with the cup-like shape of the acetabulum. An acetabular labrum attaches to the bony rim of the acetabulum and cups around the head of the femur to hold it firmly in place. Various ligaments add strength to the articulation of the hip joint and a large number of muscles act on the hip joint. The gluteus medius is primarily associated with abduction. Anterior fibers assist with flexion and internal rotation. Posterior fibers assist with extension and external rotation. These muscle groups stabilize the pelvis during a single leg support.

[0006]

Frequently, these muscle groups are compromised when surgical procedures are performed at the hip joint, especially during a hip replacement surgery. A significant problem that occurs when a hip joint has been compromised is dislocation of the hip joint. Thus, the femoral head can be driven out of the acetabulum. The hip is most susceptible to posterior dislocation when it is flexed past 90 degrees, internally rotated and adducted. Examples of this action occur in every day living, such as sitting on a low chair and leaning forward while putting weight on the affected hip joint and internally rotating when coming to a standing position. Thus, common activities of daily living, specifically excessive hip flexion with loaded extremity and internal rotation on the affected side, can cause dislocation. Anterior dislocation also occurs when a hip is externally rotated, abducted, and flexed and if, for example, a knee is subject to a force, such as accidentally hitting an object. The neck of the femur or the greater trochanter levers the femur out of the acetabulum. To avoid these problems, an orthosis must be able to effectively control the limits of extension and rotation in a patient who has experienced an anterior dislocation.

[0007]

An example of a modular, adjustable prophylactic hip orthoses can be found in U.S. Patent No. 7,048,707 assigned to the assignee of the present invention.

[0008]

There is still a need to improve the function of such an orthosis in an economical manner, while addressing a comfort level for the patient to encourage maximum prolonged usage. SUMMARY OF THE INVENTION

[0009]

The present invention is directed to a modular orthosis and to improvements in prefabricated component parts of a modular system.

[0010]

The orthosis can include a pelvic or hip engaging unit that is formed to conform to the contours of the human hip. This hip engaging unit can include multiple positional joints which can enable expansion, contraction and rotation to permit a prefabrication of the hip engaging unit and a subsequent adjustment to the particular anatomy of the patient. The hip engaging unit can include first and second relatively rigid outer hip engaging members that are adjustably connected together through a relatively flexible rear connector plate. The closure system on the front of the patient can mount the hip engaging unit on the patient. The rear connector plate can slidably mount an adjustable extension posterior spinal orthosis that can be customized to match the patient. A pair of adjustable shoulder straps are connected to the top of the extension orthosis and fastened at the bottom to the rear connector plate.

[0011]

Appropriate resilient pads of a CoolFoam™ such as neoprene, polyurethane foam or polyethylene foam or other medically acceptable resilient pads are removably mounted within each hip engaging unit to provide comfort to the user and enable washing of the pads.

[0012]

The rear connector plate includes a central elongated slot that can journal a protruding guide disc with a shaft of the disc extending through the elongated slot while the dimension of the disc guide head is large enough to only slide on the outer surface. An elongated central opening in the extension member can further accommodate a fastener such as a multi- positional compression disc to clamp the extension member at a subjective position depending upon the length of the patient's back. Appropriate resilient pads can be mounted, for example with a Velcro® swatches on the pad so that they are adjustably affixed for contact with the patient.

[0013]

An appendant orthotic member can be prefabricated in the form of a sleeve member where a diagonally semi-rigid partial cylindrical band can be adjusted in dimension to fit the thigh and knee portion of the patient. Again, appropriate resilient pads can be removably fastened to the appended sleeve member to directly bear against the patient's body. The hip engaging unit is joined to the appended thigh orthotic member by an adjustable hinge unit having bars that can be adjustably connected to both the hip engaging unit and the appended orthotic member depending on the size of the patient. The hinge member can be adjustably set to control the extent of extension and flexion.

[0014]

The hip orthoses of the present invention includes a hip engaging unit for a first body member conforming to a portion of the user's hip and a second body member conforming to another portion of the user's hip and a closure unit operatively connected to the first and second body members for exerting a retention force to the user's hip through the first and second body member. A hip posterior spinal orthotic unit has a lower portion secured by the hip engaging unit to enable positioning along the user's spine. A pair of adjustable shoulder strap assemblies are connected to an upper portion of the posterior spinal frame member and also connected adjacent the lower portion of the posterior spinal orthotic unit so that the user can readily adjust the application of retention forces about the waist and hip portion of the user with a closure unit and can further adjust a pair of adjustable shoulder strap assemblies to extend the shoulders and upper back of the user towards the posterior spinal orthotic unit. When the shoulder strap assemblies are appropriately fastened with the spinal column of the user contacting the posterior spinal orthotic unit, a stable platform is provided with the hip engaging unit so it neither rotates nor rides up on the user. Accordingly, an improved control and stabilizing of the torso translates into an improved control of both extension and flexion and abduction and adduction of the hip joint.

[0015]

Additionally, the user can readily tighten or release the forces extending the shoulder and upper back of the user against the posterior spinal orthotic unit.

[0016]

The posterior spinal orthotic unit can have a lower portion which also forms a connection and a portion of the hip engaging unit while providing an adjustable or telescoping thoracic extension member for adjusting to the length of the spinal column of the user. Respective adjustable shoulder strap assemblies can be connected to the upper portion of the thoracic extension member and to the lower portion of the posterior spinal orthotic unit adjacent the hip engaging unit. [0017]

Each one of the adjustable shoulder strap assemblies can include a first strap unit with a shoulder pad, adjustably connected to the upper portion of the spinal frame member, and a second strap unit also adjustably connected to the first strap unit and to the lower portion of the spinal frame member. The first strap unit can include a friction buckle member with the second strap unit including a strap connected to the lower portion of the spinal frame member and extending through the friction buckle member whereby the user can pull the extended straps downward on the sides of the chest for adjusting extension of the shoulder and upper back of the user, and can easily loosen the straps by relative movement of the buckle and pulling the strap forward away from the chest. Thus, by lifting a tab on the buckle, it is capable of releasing the tension and the buckle can be slid upward to provide less force and also an adequate opening for removing the orthosis.

[0018]

The present invention can also be sold as a kit to modify pre-existing hip orthoses to increase their stability.

[0019]

An orthotist can adjust the hip posterior orthotic unit to the specific size and shape of the user and can also increase or decrease the length of the adjustable thoracic extension member by an adjustable extension.

[0020]

The present invention further provides a method of stabilizing a compromised hip joint of a user by applying a hip engaging unit for removably mounting on a user and an appendant orthotic member that is configured for a removable connection to a user's leg in an operable position to enable control of extension and flexion of the leg. This position can be preferably adjacent the knee of the leg having the compromised hip joint. An adjustable hinge unit interconnects the appendant orthotic member and the hip engaging unit to permit an adjustable setting of desired extension and flexion of the leg. The movable posterior spinal orthotic unit can be extended in a cantilevered manner from the hip engaging unit to a desired position adjacent the user's spine. Applying a thoracic extension force on each of the user's shoulders, for example through the pair of adjustable shoulder strap assemblies, can pull the shoulders towards their posterior spinal orthotic unit to anchor the hip engaging unit against undesirable movement on a user. As a secondary benefit, the user's shoulders may be bent due to curvatures of the spine and this can have a corrective action in aligning the shoulders with the spine.

[0021]

This modular design enables the posterior spinal orthotic unit to adopt to different designs of hip abduction systems and permits retro-fitting of pre-existing hip orthosis to enable increased control in stabilizing a patient while still permitting a patient easy donning and removal. When properly worn the hip orthosis provides considerable rotational control and stability. Advantages are provided in the post-operative management of complicated patient situations after a hip revision. Additionally, patients with redundant soft body tissue who need additional control can secure much control with the present invention.

BRIEF DESCRIPTION OF THE DRAWINGS

[0022]

The objects and features of the present invention, which are believed to be novel, are set forth with particularity in the appended claims. The present invention, both as to its organization and manner of operation, together with further objects and advantages, may best be understood by reference to the following description, taken in connection with the accompanying drawings.

[0023]

Figure 1 is a perspective exploded view of certain components of the orthosis of the present invention;

[0024]

Figure 2 is an elevated front view of the hip orthosis applied to a user;

[0025]

Figure 3 is a perspective back view of the hip orthosis of the present invention;

[0026]

Figure 4 is a rear elevated view of the hip orthosis of the present invention;

[0027]

Figure 5 is a side view of the orthosis without the thoracic extension force; and

[0028]

Figure 6 is a side view of the hip orthosis with the application of a thoracic extension force; and [0029]

Figure 7 is a perspective view of the assembled hip orthotic of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0030]

Reference will now be made in detail to the preferred embodiments of the invention which set forth the best modes contemplated to carry out the invention, examples of which are illustrated in the accompanying drawings. While the invention will be described in conjunction with the preferred embodiments, it will be understood that they are not intended to limit the invention to these embodiments. On the contrary, the invention is intended to cover alternatives, modifications and equivalents, which may be included within the spirit and scope of the invention as defined by the appended claims. Furthermore, in the following detailed description of the present invention, numerous specific details are set forth in order to provide a thorough understanding of the present invention. However, it will be obvious to one of ordinary skill in the art that the present invention may be practiced without these specific details. In other instances, well known methods, procedures, components, and circuits have not been described in detail as not to unnecessarily obscure aspects of the present invention.

[0031]

The general principles of the present invention have been defined herein specifically to provide an improved modular component orthosis which can be combined together to form an adjustable prophylactic hip orthosis and adduction/abduction joint.

[0032]

The modular components of the present invention can be combined together to provide an orthosis that can be prefabricated and subsequently adjusted to meet the specific needs and sizes of various patients. Thus, the cost of customized orthoses can be avoided while retaining the advantages of a customized fitting to meet the specific needs of the patient. The utilization of the various modular components can be advantageously incorporated in different types of orthotic applications, since individually they each represent improvements in design and function. Collectively, the modular components can advantageously provide an improved orthosis. [0033]

A particular example of such an orthosis is an adjustable prophylactic hip orthosis with a posterior extension for stabilizing the torso and preventing dislocation of the hip orthosis.

[0034]

Our modular prophylactic hip orthosis addresses competing design goals of a relatively light and comfortable fit to the patient while stabilizing a compromised hip joint. Previous hip orthoses generally relied upon an encircling hip component that extends about the waist of a user or patient with a shield or lower extending portion of the orthotic extending on at least the side of the compromised hip. To assist in anchoring the orthotic, an appendant orthotic member was provided on the thigh of the user, for example in the form of a sleeve configuration, with an outer upper side of the sleeve member longitudinally displaced from an opposite lower portion positioned adjacent the knee, thereby providing corresponding fixation points to prevent rotational displacement of the sleeve member about the leg. An adjustable hinge member was connected on mounting bars which are anchored both on the thigh orthotic member and the hip orthotic member. An example of such a design is set forth in U.S. Patent No. 7,048,707 which is incorporated herein by reference.

[0035]

The present invention addresses improvements for further stabilizing the compromised hip joint, by recognizing the consequences of the user's daily activities and the articulation of the torso that can provide subtle dislocations of the hip orthotic, particularly in users when they have redundant soft tissue that can interfere with a hip pelvic band functioning as a forward flexion stop. Thus, patients that may tend to be obese or even patients that may be careless with their activities, are particularly prone to benefit from the additional hip motion control provided by our posterior thoracic extension.

[0036]

Referring to Figure 1, an embodiment of the present invention is disclosed although missing flexible strap assemblies and resilient cushioning pads which are shown in Figure 7. The components shown are pre-fabricated modular component parts that can be custom adjusted to match the particular size of the patient and set for a prescribed range of the motions permitted for that patient including flexion, extension, abduction and adduction. The hip orthosis 200 of the present invention, includes a pelvic or hip engaging unit 10 shown in Figure 1, having a first body member 12 and a second body member 14, configured to capture and conform to the side of a patient's hip and upper leg. Preferably, these parts are formed as well as other modular component parts, in a plastic having a high or low density polyethylene, a polypropylene, or co-polymers thereof, which can be heat-molded into a shape which can further conform to the contours of the human hip. Thus, an orthotist can further make modifications to conform the pre-fabricated hip orthosis of the present invention, to the particular anatomy of the patient/user.

[0037]

A relatively flexible plastic connector member 16 has a lower horizontal configuration in the form of a relatively flexible connector plate with a pair of elongated slots 18, 20 to enable relative adjustment of the distance between the first body member 12 and the second body member 14. A front closure unit 22 is mounted across the front of the first body member 12 and the second body member 14. A latching member 24 having a male pair of flexible prongs that can be flexibly inserted into a female coupling is provided. A first loop belt member 26 is appropriately anchored by a rivet to the second body member 14 to locate the female side of the latch member. A second belt member 28 is anchored at one end of the first body member 12 and it extends to an adjustable buckle 30 having nap material that permits a hook material at the other end of the belt, to adhere. This material can be of the well known Velcro® configuration. A relatively flexible strip or band of plastic 32 can be appropriately mounted to the second belt member 28 or even anchored on one end of either the first body member 12 or the second body member 14, to provide a force dispersing strip across the user's waist for spreading the compression forces upon tightening of the closure unit 22. While not shown in Figure 1, neoprene pads 29,31 can be removably attached, for example by a hook and nap material 34 located at various portions on the interior of both the first body member 12 and the second body member 14 to provide a cushioning effect between the patient's body and the orthotic components.

[0038]

A posterior spinal orthotic unit 36 includes an adjustable thoracic extension member 38 as a cantilevered upper portion and the connector member 16 as the lower portion. As can be seen, the connector member 16 has a relatively inverted T-shape with a vertically extending elongated slot 40. The lower end of the elongated slot 40 has an enlarged circular hole 42 that is dimensioned to receive a guide pin 44 with an enlarged disc guiding head that can extend through the enlarged circular hole 42 and then be journaled within the slot 40 to accommodate relative vertical movement as indicated by the arrows in Figure 1 to provide adjustment to fit the spinal column of the particular patient by a relative slidable extension and/pr contraction of the thoracic extension member 38.

[0039]

The thoracic extension member 38 also includes an elongated slot 46 that assists in removing component weight and also enables a compressive attachment by a fastening unit 48 that comprises a male fastening member 50 with a threaded post that can be inserted through the elongated slot 46 and through an anchoring hole 54 in a connector member 16, see Figure 3. While not shown, an Allen wrench can be inserted into a hexagonal opening on the face of the male fastening member 50 to thread the post member into the female fastening member 52. The upper portion of the thoracic extension member 38 can have a longitudinal central curved portion to provide additional strength with one or more holes, to reduce weight.

[0040]

Both the thoracic extension member 38 and the connecting member 16 can be formed from a heat moldable acrylic modified PVC, for example of a material commercially known as Kydex® sold by Kleerdex, Inc. The thickness of the material depends somewhat on the particular size of the model but can generally be in a range of 1/8 of an inch. Thus, a relatively flexible thoracic extension member 38 can be anchored and cantilevered upward from the connector member 16 along the user's spinal column. Slanted elongated slots 56 and 58 are provided at a bowed enlarged upper head of the thoracic extension member 38 to serve as securement anchors for shoulder straps 94, 104, to be discussed subsequently.

[0041]

As can be seen, other fastening units 48 can be employed to fasten the respective first body member 12 and second body member 14 through the horizontal elongated slots 18 and 20 in the connector member 16. While not shown, an abrasive surface of a sandpaper configuration, can also be utilized as an interface between surfaces of the connector member 16 around the respective slot members, and mounting holes at the ends of the respective complementary portions of the first body member 12 and second body member 14. These abrasive surfaces can prevent any relative rotation because of the friction texturing. [0042]

An adjustable hinge unit 60 includes a hinge member 62 that can be adjustably mounted on an upper support plate or bar 64, and also adjustably mounted on a lower support plate or bar 66. Preferably, the hinge member 62 and respective support bar 64 and 66 are made of metal.

[0043]

The upper end of the upper support bar 64 has a curved securement portion 68 that is complementary to a curved anchor mount 70 on the second body member 14. While not shown, the first body member 12 also has an equivalent anchor mount portion.

[0044]

The hinge member could be any of a number of different types of orthopedic hinge assemblies that will provide an adjustable range of movement about an axis. An example of such a hinge assembly can be found in U.S. Patent No. 5,460,599, which is incorporated herein by reference and also in U.S. Patent No. 5,421,810, which is also incorporated herein by reference. These hinge units 60 provide a relatively compact profile and an adjustable anchor range of movement to control flexion and extension of the leg appendage

[0045]

The appendant orthotic member 72 includes a cross-sectional C-shaped curved half cylinder body member 74 formed of the same plastic materials utilized on the respective body members of the hip engaging unit 10. A cantilevered flexible panel 76 is made from approximately the same material that is utilized for the flexible plastic band 32 of the hip engaging unit 10. The flexible panel 76 serves a similar function in dissipating some compressive forces when the thigh appendant orthotic member 72 is mounted on an appendage of the patient/user. Hook and nap material 78, 80 such as Velcro® is mounted on strips in the interior of the body member 74 to serve the same function of permitting a resilient and washable pad 88 to be mounted on the interior of the appendant orthotic member 72 to provide a comfortable fit on the thigh.

[0046]

On an inner portion of the appendant orthotic member 72, extending towards the knee, is a longitudinally elongated segment 82. This arrangement on one side of the appendant orthotic member 72 permits a lower fixation point to be longitudinally displaced from the other side adjacent the skeletal structure of the knee joint which has less fat or soft tissue. This assists in preventing rotational displacement for the appendant orthotic member 72. An anchor location 84 is provided on the exterior other side of the appendant orthotic member 72 to permit an adjustable connection with the lower support bar 66.

[0047]

Referring to Figure 2, the hip orthosis 200 as shown is a frontal view mounted on a patient. The edges 86 of removable flexible pads 29, 31 are shown extending beyond the edges of the hip extending unit 10 with a removable flexible pad 88 also extending beyond the appendant orthotic member 72.

[0048]

As shown in Figure 2, a first adjustable shoulder strap assembly 90 and a second adjustable shoulder strap assembly 100 have been donned by the user while the hip engaging unit 10 and the appendant orthotic member 72 have been affixed to the thigh. As can be readily appreciated, usually a physician or an orthotist will have adjusted these component parts for a particular body size of a patient. Thus, the patient can slip his/her arms through the appropriate first and second shoulder strap assemblies 90, 100, can fasten latch member 24 to securely attach the hip engaging unit 10 and also fasten the thigh belt 110 to the thigh latch member 112 and also latch the second thigh belt 114 to the second thigh latch member 116 to securely anchor the appendant orthotic member 72 onto the thigh of the user.

[0049]

The first adjustable shoulder strap assembly 90 includes a shoulder pad 92 that can comfortably dissipate the forces from an upper strap 94 when a quick release buckle 96 such as a Tri-Glide buckle from High Techs Corp. is cinched tight by pulling a lower strap 98. The strap 94 is journaled within the oblong slot 56 in the thoracic extension member 38. The second adjustable shoulder strap assembly 100 has equivalent components including the shoulder pad 102, the upper strap 104, a similar quick release buckle 106 and a lower strap 108.

[0050]

As can be seen in Figure 3, a rivet can extend through a T portion of the connector member 16 on either side to fasten and anchor one end of the respective lower straps 98 and 108. The free ends of the straps extend through the respective quick release buckles 96 and 106 and when pulled downward, firmly fasten onto the patient as the patient's back is pulled into contact with the thoracic extension member 38. One or more removable thoracic pads, and preferably two separate pads 1 18, 119, are mounted, again with hook and nap material to provide a resilient contact with the back of the user across the thoracic extension member 38 and the connector member 16. The respective upper straps 94 and 104 extend through buckles 120 and 122 and are sewn to the respective shoulder pads 92 and 108. The buckles 120 and 122 permit a limited adjustment of the shoulder pads 92 and 102 for sizing the shoulder strap assemblies to the particular user.

[0051]

Figure 5 is an illustration of a user pulling downward a free end of the lower strap 98 that slides through the quick release buckle 96 to pull the shoulders backwards for contact with the posterior spinal orthotic unit 36. The thoracic extension member 38 is flexibly placed against the user's spinal cord.

[0052]

Because the prime purpose of the posterior spinal orthotic unit 36 and the pair of adjustable shoulder strap assemblies 90 and 100 are to provide stabilization of the torso to prevent any riding up or rotation of the hip engaging unit 10, the thoracic extension member 38 can be relatively flexible, thereby permitting some limited movement of the patient. This adds to the comfort of the patient but also still has a secondary effect of appropriately adjusting the posture of the patient to provide a remedial byproduct of hyperextension on the spinal column.

[0053]

As can be seen in Figure 6, compressive forces are provided by the hip engaging unit 10 while the respective adjustable shoulder strap assemblies 90 and 100 provide forces to pull the user's shoulders back to a stable position against the thoracic extension member 38. Such an arrangement will not cause constriction across the user's chest that might impair breathing and can further be readily adjusted to accommodate sitting or other motions of the user with relatively easy releases of the respect quick release buckles 96 and 106. The strap configuration of this design also provides an anti-twist operation to assist users with limited shoulder mobility. The padded shoulder pad design with the straps can be loosened without completely unfastening in order to facilitate an uncomplicated re-application to the user.

[0054]

As can be seen, when initially applied in Figure 5, the adjustable shoulder strap assemblies 90 and 100 are loosely positioned across a user's shoulders with the adjustable strap and buckle combination available on the respective right and left hand side of the chest of the user. In Figure 6 the user grasps the respective free ends of the straps 98 and 108, extending through the respective quick release buckles 96 and 106 and by pulling downward, can extend the user's shoulder and upper back to contact the cantilevered thoracic extension member 38.

[0055]

Thus, a thoracic extension force can be applied to each of the shoulders of the user to force the user's shoulders towards the posterior spinal orthotic unit 36 and thereby provide a firm anchor position. By releasing the hold of the buckles 96 and 106, the straps 98 and 108 can be loosened to adjust the desired force for the user. As can be readily appreciated, the user's arms are not encumbered by any apparatus pressing against his or her chest and by facilitating the application and the disassembly of this orthotic from the user, the user is encouraged to utilize the orthotic for extended periods. The adjustability accommodates the user when sitting or assuming other positions with an economy of movement.

[0056]

Those skilled in the art will appreciate that various adaptations and modifications of the just-described preferred embodiment can be configured without departing from the scope and spirit of the invention. Therefore, it is to be understood that, within the scope of the amended claims, the invention may be practiced other than as specifically described herein.

Claims

CLAIMS What Is Claimed Is:

1. A hip orthosis comprising: a hip engaging unit including a first body member conforming to a portion of a user's hip, a second body member conforming to another portion of a user's hip, and a closure unit operatively connected to the first and second body members for exerting a retention force on the user's hip through the first and second body member; a posterior spinal orthotic unit having a lower portion secured by the hip engaging unit to enable positioning along the user's spine; and a pair of adjustable shoulder strap assemblies connected to an upper portion of the posterior spinal frame member and adjacent the lower portion of the posterior spinal orthotic unit wherein the user can adjustably apply a retention force about a waist and hip portion of the user with the closure unit and can adjust the pair of adjustable shoulder strap assemblies to extend the shoulders and upper back of the user towards the posterior spinal orthotic unit.

2. The hip orthosis of Claim 1 further including an appendant orthotic member configured for connection to a user's leg at an operative position to control extension and flexion of the leg and a hinge unit interconnecting the appendant orthotic member and the hip engaging unit.

3. The hip orthosis of Claim 2 wherein the posterior spinal orthotic unit includes a thoracic extension member as an upper portion and a connector member as the lower portion for engaging the first body member and the second body member.

4. The hip orthosis of Claim 3 wherein the thoracic extension member is adjustably mounted to the connector member to enable adjustment to the specific user.

5. The hip orthosis of Claim 4 wherein the connector member is adjustably mounted to the first body member and the second body member to enable adjustment to a particular anatomy of the user.

6. The hip orthosis of Claim 5 wherein a plurality of multi-positional joint members that enable relative expansion, contraction and rotation connect the connector member to respectively the first body member, second body member and thoracic extension member.

7. The hip orthosis of Claim 5 wherein the connector member has an inverted T-shape with a pair of horizontal elongated slots to enable adjustable connection to the hip engaging unit and a vertical elongated slot to enable adjustable connection to the thoracic extension member.

8. The hip orthosis of Claim 7 wherein the thoracic extension member includes a vertical elongated slot and a guide disc journaled in the vertical elongated slot of the connector member and one of the multi-positioned joint members is journaled in the vertical elongated slot of the thoracic extension member.

9. The hip orthosis of Claim 3 wherein the thoracic extension member has a flat lower portion with a vertically slotted elongated opening and a protruding guide disc and a curved upper portion with openings to secure the pair of adjustable shoulder strap assemblies.

10. The hip orthosis of Claim 9 wherein the connector member has a pair of horizontal elongated slots configured for adjustable connection to the hip engaging unit, a vertical slot configured for adjustable connection to the thoracic extension member and securement members for connection to the pair of adjustable shoulder strap assemblies.

11. The hip orthosis of Claim 3 wherein the posterior spinal orthotic unit is formed of semi-rigid plastic components.

12. The hip orthosis of Claim 3 wherein each adjustable shoulder strap assembly includes a first strap unit with a shoulder pad connected to an upper portion of the thoracic extension member and a second strap unit adjustably connected to the first strap unit and to the connector member.

13. The hip orthosis of Claim 12 wherein each first strap unit includes a friction buckle member and each second strap unit includes a strap, connected to the connector member and extending through the friction buckle member whereby the user can pull the strap for adjusting an extension of the shoulder and upper back of the user.

14. The hip orthosis comprising: a hip engaging unit configured for removable mounting on a user; an appendant orthotic member configured for removable connection to a user's leg at an operative position to enable control of extension and flexion of the leg; an adjustable hinge unit interconnecting the appendant orthotic member and the hip engaging unit for setting an amount of extension and flexion of the leg; a posterior spinal orthotic unit having a lower portion secured by the hip engaging unit and configured to cantilever upward adjacent the user's upper back from the user's waist; and a pair of adjustable shoulder strap assemblies connected to an upper portion of the posterior spinal orthotic unit and adjacent the hip engaging unit whereby the user can adjust the pair of adjustable shoulder strap assemblies to extend the shoulder and upper back of the user to contact the cantilevered posterior spinal orthotic unit.

15. The hip orthosis of Claim 14 wherein the posterior spinal orthotic unit includes an adjustable thoracic extension member on the upper portion and a connector member engaging the hip engaging unit and means for permitting a relative slidable extension and/or contraction and subsequent fastening of the adjustable thoracic extension member at a position adjusted to the user's spine.

16. A method of stabilizing a compromised hip joint of a user comprising the steps of: applying a hip engaging unit for removable mounting on a user; applying an appendant orthotic member configured for removable connection to a user's leg at an operative position to enable control of extension and flexion of the leg; setting an adjustable hinge unit interconnecting the appendant orthotic member and the hip engaging unit to control extension and flexion of the leg; adjusting a movable posterior spinal orthotic unit to extend in a cantilevered manner from the hip engaging unit to a position adjacent the user's spine; and applying a thoracic extension force on each of the user's shoulders to pull the shoulders toward the posterior spinal orthotic unit to anchor the hip engaging unit against undesirable movement on the user.

17. The method of Claim 16 further including providing a user adjustable control for each application of thoracic force on a chest of the user whereby the user can tighten and/or release the thoracic shoulder forces.

18. In a hip orthosis having a hip engaging unit for stabilizing a compromised hip joint of a user by controlling flexion/extension and abduction/adduction, the improvement comprising: a posterior spinal orthotic unit having a lower portion configured for securement by the hip engaging unit and configured to cantilever upward adjacent the user's upper back from the user's waist; and a pair of adjustable shoulder strap assemblies configured for connection to an upper portion of the posterior spinal orthotic unit and adjacent the hip engaging unit whereby the user can adjust the pair of adjustable shoulder strap assemblies to extend the shoulder and upper back of the user to contact the cantilevered posterior spinal orthotic unit.

19. The hip orthosis of Claim 18 wherein the posterior spinal orthotic unit includes an adjustable thoracic extension member on the upper portion and a connector member engaging the hip engaging unit and means for permitting a relative slidable extension and/or contraction and subsequent fastening of the adjustable thoracic extension member at a position adjusted to the user's spine.

20. The hip orthosis of Claim 19 wherein the connector member has at least one horizontal elongated slot to enable adjustable connection to the hip engaging unit and a vertical elongated slot to enable adjustable connection to the thoracic extension member, and wherein each adjustable shoulder strap assembly includes a first strap unit with a shoulder pad connected to an upper portion of the thoracic extension member and a second strap unit adjustably connected to the first strap unit and to the connector member.