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KO K AFO, Blounts and Physiologic Genu Varum/Valgum KAFO’s Variations

1399 E. Western Reserve Road • Poland, Ohio 44514 Toll Free: 1-800-837-3888 • Phone: (330) 757-3569 • Fax: 1-800-65PRAFO Web: www.AnatomicalConceptsInc.com • Email:Info@AnatomicalConceptsInc.com

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Index Page 2‌‌‌‌‌‌‌‌‌..V-Vas™ Knee Orthosis and its Unique Joint System Page 3........ Management of Severe OA using a V-Vas™ Customised Off Loading Knee-Orthosis Page 4-7‌‌‌.......V-Vas™ - A New Concept In Unloader Knee Orthosis Design Page ‌‌‌‌‌‌‌‌‌‌..‌‌‌‌‌‌‌‌‌V-Vas™ Orthometry Form Page ‌‌‌‌‌‌‌‌‌‌.V-Vas™ Fracture / Post Operative Knee Orthosis Page 1‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌...V-Vas™ KO with AFO Attachment Page 1-1‌...‌‌‌‌‌‌‌‌‌‌‌‌..................... V-Vas™ Blounts KAFO Page 1-1‌‌ V-Vas™ Blounts KAFO Clinical and Radiographic Outcomes Page 1-‌‌‌‌‌‌‌‌‌‌... V-Vas™ Blounts KAFO How does it Work? Page 2..‌‌‌‌‌‌‌‌‌‌‌...‌.P Physiologic Genu Valgum V-Vas™ KAFO Page 2..‌‌‌‌‌‌‌‌‌‌‌‌‌..‌...Hemiepiphysiodesis V-Vas™ KAFO Page 2-2‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌..‌.......V-Vas™ Bariatric KAFO’s Page 2‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌.....V-Vas™ Low Profile KAFO Page 2‌‌‌‌‌‌‌‌‌‌‌...‌‌..V-Vas™ KAFO with Step™ Lock Joint Page 2‌‌‌‌‌‌‌‌‌V-Vas™ Fracture KAFO with Lerman ROM Joints Page -‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌..‌‌V-Vas™ Functional KAFO’s Page 3‌‌‌‌‌‌‌‌‌‌....PENTAGON™ “Five Function Knee Orthosisâ€? Page 3‌‌‌‌‌‌‌‌‌‌‌‌‌..‌. KMOÂŽ (Knee Management Orthosis) Page 3 ‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌..‌‌‌‌KMOÂŽ Sizing Chart Page 3‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌.....TRANSCONNECTOR™ KAFO

Š Anatomical Concept, Inc. Phone: 800-837-3888

www.AnatomicalConceptsInc.com Patent: 6,387,066 Fax: 800-657-7236 Email: Info@AnatomicalConceptsInc.com


Varum-Valgum Adjustable Stress Custom Offloading Knee Orthosis Achieve optimal varum or valgum stress, without bulky or complex adjustments. The ďŹ rst long axis off-loading custom knee orthosis that doesn’t need to be removed to adjust off-loading and the mechanical axis is always non-binding and auto aligning. s/STEOARTHRITIS"RACE s Finite VARUMORVALGUM !DJUSTABLE3Tress s &EATURING,ONG!XIS !DJUSTABLE/fF LOADING 5PRIGHT3YSTEM s !DJUSTABLEWHILEON PATIENTSEXTrEMITY 3INGLESCrEW ADJUSTMENTSTOTHE 4HIGH#ALFSEGMENTS to or corrective forces.

This orthosis was designed for osteoarthritic patients and provides ďŹ nite adjustability to optimize off-loading tolerance. The V-VAS™ orthosis is capable of providing adjustments to the Femoral and the Tibial sections either in combination or individually while the mechanical axis stays non-binding and auto aligning.

Auto Aligning Polycentric Joints

Femoral displacement is accomplished by adjusting the upper screw set. This is accomplished without causing the Tibial section to move. These illustrations depict actual capabilities of the V-VAS™ joint system but are exaggerated for visual purposes.

Patent: 6,387,066

Tibial displacement is accomplished by adjusting the lower screw set. This is accomplished without causing the Femoral section to move.

Manufactured and distributed by:

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6284-1/09

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SUMMARY: This study reports the results of using a custom-made knee orthosis, the V-VASTM as an alternative to surgical intervention INTRODUCTION: Various orthosis designs exist for the management of patients with osteoarthritis of the knee. Custom or o -the-shelf unloader knee orthoses are widely used for relieving pain during weight bearing activities in patients with uni-compartmental osteoarthritis. Although these designs can be mechanically successful, patient tolerance may be low due to a higher concentration of pressures being exerted by straps or condylar pads. This is especially so with severe deformity and can limit the duration over which an orthosis can be tolerated. The authors have applied a new custom orthosis design (V-VASTM) in an experience of over 100 ttings. This design was investigated due to its ability to ne-tune comfort levels at tting, its light weight and relatively e cient biomechanical design. METHODS: The Varum Valgum adjustable stress (V-VAS™) custom knee orthosis is a new concept for treating patients who present with medial or lateral compartmental arthropathies. Its design incorporates features intended to increase both e ectiveness and compliance. Instead of using a narrow frame as seen on most designs, it uses a total contact cu on the thigh and tibia along with an adjustable, self aligning, polycentric joint system to create four points of pressure instead of three. There is no need for a condylar pad. This results in increased comfort.

At the tting stage, the design of the orthotic joint was such that ne adjustments of the amount of o oading were possible. Immediate feedback on pain relief was a very positive aspect of the design. By encouraging the patient to walk up and down stairs ar the tting stage, the orthotist was able to ne tune the brace performance without the need to remove and reapply. Radiological assessment before and after use and the decrease in pain on movement were the primary methods of measurement of clinical e ectiveness. RESULTS: Due to the age range it was important the brace was simple to apply, lightweight and neat in appearance as a high level of compliance was important. The aim of the bracing strategy was to reduce as much as possible the pain levels and where appropriate, increase levels of mobility. Group 1- All patients were asked after 6 weeks if they would willingly return the device - All refused.

Sample Case ( MD - 47yrs ) History t 1985 left knee arthroscopy & open medial menisectomy t 1995 repeat arthroscopy shows complete loss of medial chondral surface t 2005 right knee arthroscopy - bone on bone contact. Both knees moderate PFJ and lateral compartment chondral loss. Examination t Bilateral clinical varus >20 degrees t Both knees lack 5 degrees full extension t Moderate e usion right knee only t Severe pain and swelling right knee Observations t Too young for joint replacement t Too severe for chondral resurfacing t Too advanced for high tibial osteotomy t May be suitable for Benjamin’s double osteotomy Interpretation of Outcomes t Brace initially used 2 - 4 hours per day t Now used during working day t Excellent reduction in pain and swelling of right knee t Weight-bearing Xray t No brace 11 deg Varus t With brace 4 deg Varus

The system’s self-aligning, polycentric hinge design, has a means of linearly adjusting the varum or valgum angle (depending on which compartment is a ected) without causing mechanical joint binding. Even with quite severe deformity the joints t close to the knee without binding.

The two main patient groups selected for the V-VAS were those presenting with valgus /varus deformity of the knee in excess of 10 degrees and medically un t for surgery (GROUP 1), or those too young to be considered for knee replacement surgery (GROUP 2). In Group 2, bracing was seen as an earlier option than osteotomy and could be used in conjunction with pain-relieving injection therapy Patients liked the fact that the design closely followed the pro le of the knee without binding. Each patient was assessed radiographically and a custom cast made of the knee. Partial correction of deformity by the orthotist during cast taking was found to be important in minimising user discomfort. The patient’s perception of pain was used as an indicator of the optimum position during cast taking. It is likely that by demonstrating that pain relief could be achieved during casting, the patients expectations of the brace were raised.

Orthotist - Anatomical Concepts (UK) Ltd, Scotland Consultant Orthopaedic Surgeon, Inverclyde Hospital, Scotland Bioengineer - Anatomical Concepts (UK) Ltd, Scotland

All patients reported reduction in their pain by 50-70% using a simple 1-10 visual-analogue pain scale. Over 50% reported an increase in mobility in terms of their day to day tasks. Based on their individual experience, patients had a further 5cm distraction added at this point. In all cases the patients reported that the quality of life outcomes exceeded their expectations. Group 2 - One patient found the brace di cult to use due to a hypersensitivity following trauma and derived little or no bene t. One patient had initial bene t, reporting 50% pain reduction, however went on to elect for surgery . The remainder reported reduction in pain by 50-70%. They were not willing to go without their brace. Mobility was improved with around 10% returning to some form of activity such as the gym or hill walking. Two patients who were clinically obese reported migration of the brace in-situ as a problem. CONCLUSION: The V-VAS was found to be an ethical and e ective device in both study groups with 90% demonstrating signi cantly improved pain and mobility REFERENCES: 1. 2.

Finger S, Paulos LE. Clinical and Biomechanical Evaluation of the Unloading Brace. Journal of Knee Surgery 2002; 15: 155-159. Pollo FE, Otis JC, Backus SI, Warren RF, Wickiewicz TL. Reduction of Medial Compartment Loads with Valgus Bracing of the Osteoarthritic Knee. The American Journal of Sports Medicine 2002; 30:3: 414-421

3 © Anatomical Concept, Inc. Phone: 800-837-3888

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V-VAS™ A NEW CONCEPT IN CUSTOM OFFLOADING KNEE ORTHOSIS DESIGN Joseph W. Whiteside CO The use of custom or off-the-shelf unloader knee orthoses in both single and double upright design configurations have been successfully used in the management of patients with medial compartment osteoarthritis of the knee1-5. The mechanism to achieve this is a three point pressure system which creates an offloading moment of the affected compartment. How this offloading moment is achieved, is through a fixed or an adjustable structural frame being used as a counterforce to an adjustable strap(s) and/or an adjustable condylar pad that act as a corrective force. In more recent designs, a lengthening adjustment has been added to the proximal upright that allows for an angular shifting of the forces to create the offloading moment. Studies have shown that the offloading forces exerted by these devices are successful in relieving pain in those patients with uni compartmental osteoarthritis during weight bearing activities2,3,6. Although these designs have been successful, many times there is a certain degree of intolerance to the unloader knee orthosis that is experienced by the patient. This intolerance is typically due to a higher concentration of pressures being exerted by the strap or condylar pad, which can limit duration of use. As offloading adjustments are being made in the double upright designs, the frame configurations of the unloader orthosis do not follow a natural progression as oriented to the long axis of the leg when viewed in the coronal plane. As the corrective forces are applied to obtain the optimal offloading moment, there is an inability to distribute these forces proportionally through the leg. This leads to an inability to better match the center of rotation of the leg as viewed in the coronal plane, which can further limit compliance. In addition, the three points of pressure used in both designs are applied by laterally or medially shifting the femur and/or tibia to offload the affected compartment. This lateral or medial shift causes a certain amount of shear to the mechanical knee joint(s) resulting in a varying degree of binding with in the mechanical joint(s). This mechanical binding can further restrict the patients ability to freely flex and extend there knee during various activities of daily living. This shifting of the uprights and binding of the mechanical joint(s) that are felt by the patient can decrease the ability for the patient to comply with a single or double upright unloader knee orthosis. The Varum Valgum Adjustable Stress (V-VAS™¹) custom unloader knee orthosis is a new concept in treating patients who present with medial or lateral compartmental arthropathies. Its custom design incorporates several unique features that increase the effectiveness and compliance for the patient who is in need of an unloader orthosis. ¹ V-VAS™ is fabricated and distributed by Anatomical Concepts Inc., Poland, OH 44514-3250

American Academy of Orthotists and Prosthetists

©Anatomical Concept, Inc. Phone: 800-837-3888

2006 Chicago IL.

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V-VAS™ A NEW CONCEPT IN UNLOADER KNEE ORTHOSIS DESIGN Instead of using a narrow frame as seen on most all double and single upright designs it uses a total contact cuff on the thigh and tibia along with a unique adjustable self aligning polycentric joint system to create four points of pressure instead of three. With two points of pressure being applied as a counter force (located at the proximal and distal ends of the thigh and tibial cuffs on the affected side of the leg) and two points of pressure applied as the corrective force (located at the distal and proximal ends of the thigh and tibial cuffs respectively on the non affected side of the leg) to offload the affected compartment, there is no need for a condylar pad. As compared to the single upright design, the use of a counterforce strap is not necessary once again, due to the four points of pressure used to create the offloading moment. Its self aligning polycentric hinge design, features an efficient and effective means of linearly adjusting the varum or valgum angle (depending on which compartment is affected) without causing mechanical joint binding. This is a very practitioner friendly design due to the mechanical joint never needing re-squared. The V-VAS™ has been very effective in the clinical management of patients with symptomatic medial compartment osteoarthritis. Other successful applications include, lateral compartment osteoarthritis on patients with no abnormal genu valgum alignment up to 30º of semi flexible genu valgum, non-operative tibial plateau fractures, failed hardware or reconstruction of the tibial plateau, tibial plateau and or femoral condyle spacers and post total knee arthroplasty. The V-VAS™ is currently available in a custom design. The finished design consists of a polypropylene constructed posterior opening thigh and tibial cuff that include a corrugation, to increase transverse plane integrity. The V-VAS™ is secured to the extremity via a Velcro® popliteal strap, wrap around thigh and distal tibial cuff straps. The thigh and tibial cuffs are connected via a medial and lateral self aligning polycentric knee joint. One of the self aligning joints (placed on the affected side of the leg) has the ability to be lengthened linearly at its proximal and distal ends. The lengthening can be adjusted proportionally or disproportionately proximally (thigh) and/or distally (tibia) to accommodate varying proportions of soft tissue compression. This linear (lengthening) adjustment is achieved via a counter clockwise rotation of the adjustment screw. The opposing self aligning polycentric joint in the V-VAS™ design is static and functions as a fulcrum to the adjustable self aligning polycentric joint. This ability to lengthen the upright in a linear motion allows for an anatomically correct varum or valgum force to be applied to the femur and tibia through the soft tissues via the thigh and tibial cuffs respectively. The ability to lengthen the adjustable upright either proportionally or disproportionately is how the optimal offloading moment is achieved. The self aligning joints in combination with the linear adjustment are at the heart of the uniqueness of the VVAS™. The joint construction consists of a polycentric design that allows for a medial or lateral pivoting motion in the coronal plane. This pivoting motion is achieved through the use of two spherical bearings that are at each axis within the joint head. This design feature not only allows for uninhibited flexion and extension to 180º, but an ability to compensate for varying degrees of angulations as viewed in the coronal plane within the joint head. This ability to pivot accommodates the elongation of either the proximal and/or distal upright, resulting in the self aligning feature.

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V-VAS™ A NEW CONCEPT IN UNLOADER KNEE ORTHOSIS DESIGN Suspension and anti-migration are accomplished through a removable silicon laden popliteal strap pad and tibial cuff pad. Comfort is further achieved through a removable thigh cuff liner. In a resent case study of a 51 year old male, 5'11" tall and weighing 220 pounds. The radiographs of the treated leg showed a 5º or 5 mm improvement in lateral condyle separation while fully weight bearing, using the V-VAS™ (Figure 1) versus the radiograph of the non-treated leg (Figure 2). This offloading moment of the lateral compartment allowed this patient to ambulate with minimal pain while wearing the orthosis.

Figure 1. Shows an increase in the lateral condyle space of 5º or 5mm in a full weight bearing position while wearing the V-VAS™ offloading custom knee orthosis.

Figure 2. Shows the collapsed lateral condyle space in a full weight bearing position when no orthotic intervention is used.

There are many design options available to those patients needing offloading knee orthoses. We know from reviewing literature that offloading orthoses are both ethical and very effective. There application will minimize use of medication, delay arthroplasty in the younger patient and control pain in those patients with co morbidity. They are also used as a pre-operative tool or post operative tool to determine the success of a surgical technique or offloading of the operative compartment respectively. As health care professionals we should strive for optimal outcomes when recommending various designs. Compliance, effectiveness and efficiency in design are all key factors in achieving this optimal result in the current healthcare arena. The unique features in this new design are an efficient and effective alternative used to achieve optimal results. REFERENCES 1. Finger S, Paulos LE. Clinical and Biomechanical Evaluation of the Unloading Brace. Journal of Knee Surgery 2002; 15: 155-159. 2. Pollo FE, Otis JC, Backus SI, Warren RF, Wickiewicz TL. Reduction of Medial Compartment Loads with Valgus Bracing of the Osteoarthritic Knee. The American Journal of Sports Medicine 2002; 30:3: 414-421.

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V-VAS™ A NEW CONCEPT IN UNLOADER KNEE ORTHOSIS DESIGN 3. Self BP, Greewald RM, Pflaster DS. A Biomechanical Analysis of a Medial Unloading Brace for Osteoarthritis in the Knee. Arthritis Care Research 2000; 13:4: 191-197. 4. Draper ERC, Cable JM, Sanchez-Ballaster J, Hunt N, Robinson JR, Strachan RK. Improvement in function after valgus bracing of the knee. The Journal of Bone and Joint Surgery 2000; 82-B:7: 1001-1005. 5. Giori NJ. Load-shifting brace treatment for osteoarthritis of the knee: A minimum 2½year follow-up study. Journal of rehabilitation Research & Development. March/April 2004; 41:2: 187-194. 6. Nadaud MC, Komistek RD, Dennis DA, Anderele MR, Kubo MB. “In Vivo ThreeDimensional Determination of OA Brace Effectiveness: A Multiple Brace Analysis” from the written material for a lecture delivered at American Academy of Orthopaedic Surgeons 72nd Annual Meeting, 2005.

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CUSTOM ORDER FORM

1399 E. Western Reserve Road Poland, Ohio 44514-3250

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UPS Other Next Day 2 Day

P.O. #:

3 Day

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Ship to: Due Date:

Address: City:

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Bill to:

Zip:

Address: City:

Contact Person: Phone Number:

M-L

Patients name: Height:

Weight:

State: Cir.

Zip:

For custom to measurements option (without mold) and for optimum fit and results we suggest providing us with ALL of the measurements

Age:

2“

Diagnosis:

2“

Right leg

Left leg 2“

Affected Compartment:

Requested finished length taken on the affected side

(circle one)

Medial/Varum Condition

3“ 2“

Lateral/Valgum Condition

2“

( I want the Medial Compartment Unloaded ) ( I want the Lateral Compartment Unloaded )

Plastic color:

2“

(circle one)

Black (Standard) Opaque

2“

Strap Color:

Requested finished length taken on the affected side

2“

(circle one)

Black (Standard) White

2“

Additional Comments:

For custom to mold option and for optimum fit and results we suggest providing us with the measurements

Casting Tips (for custom to mold options)

Lining (removable) The standard and recommended liner has terry cloth with silicone adhesion strips

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Patent #6,387,066

© Anatomical Concept, Inc. Phone: 800-837-3888

1. Take a non weight bearing mold with the leg in a corrected position. 2. It is helpful to align the leg in the frontal and sagital plane in the most pain free position (slight distraction may be beneficial). 3. Place the knee in a comfortable fully extended position (as possible). 4. It is advisable to complete all of the measurements. 5. Place the cast removal cutting strip on the posterior aspect of the leg. 6. Mold to be a minimum of 10” above and below the knee center. 7. Outline the border of the patella with an indelible pencil. 8. Locate and mark the knee center.

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Fracture / Post Operative KO

Anterior

Posterior

· Non operative / Post operative management · · Osteocondritis · Tibial plateau fracture · · Femoral condyle fracture · · Modify to standard length for long term application · ©Anatomical Concept, Inc. Phone: 800-837-3888

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AFO Addition to KO

· AFO can be added to offset conical shape of calf · · Improved rotational control ·

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Because are not little adults...

A unique Blounts disease or Physiologic bowing KAFO system. Let Anatomical Concepts help you... help your pediatric patients! The newest KAFO system for treatment of the infant, juvenile and adolescent patient. • Free motion knee joints • Improved compliance • Dynamic self aligning polycentric ® knee joint • Maximum growth accommodation with liner and upright growth adjustments • Independent adjustment of the tibial and femoral angles to optimize corrective forces • Custom fabricated by experienced technicians • Posterior (recommended) or anterior opening • Saves on fitting and follow up time • Also available for your adult and Bariatric patients L2036, L2387* x 2, L2820, L2830 and L2760 x 4 – suggested HCPCS codes per extremity

*Auto Aligning Free Motion Polycentric Joints 7/2009

4/2010

Providing innovations in Concept, Design and Application!

Other ACI orthoses available in pediatric and infant sizes. Patents: 6,464,659 5,088,479 5,545,127 5,486,157 5,593,383 5,944,679 5,908,398 6,302,858 6,377,178 European Patent: EP 0 931 525-B1

6,350,246 6,793,638 7,112,118

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6,387,066 7,112,016 Patent Pending

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Blounts KAFO

· Free motion · Posterior opening · · Linear adjustability · Improved compliance ·

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Blounts KAFO Outcomes.

Clinically

Initial visit

Six month follow up

Patient’s wearing schedule consisted of 10-12 hours of daily wear - during waking hours only.

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Blounts KAFO Outcomes.

Radiographic

Initial visit

(DOB 8-2007)

Ten month follow up

Patient’s wearing schedule consisted of 10-12 hours of daily wear - during waking hours only.

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Blounts KAFO How Does it Function?

Tibial adjustment Tibia Adjustment â&#x20AC;&#x201C; shows lengthening adjustment of the knee center to heel base by repositioning the distal medial tibial cuff via set screws to create isolated tibia valga corrective force.

Design allows incremental application of corrective forces to maximize tolerance and final outcome with optimal patient compliance. ŠAnatomical Concept, Inc. Phone: 800-837-3888

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Blounts KAFO How Does it Function?

Femoral adjustment Femoral Adjustment â&#x20AC;&#x201C; shows lengthening adjustment of the knee center to medial proximal thigh cuff edge by repositioning the medial thigh cuff more proximally via set screws to create isolated femoral valga corrective force.

Design allows incremental application of corrective forces to maximize tolerance and final outcome with optimal patient compliance. 16

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Blounts KAFO How Does it Function?

Tibial and Femoral Adjustment Tibia Adjustment and Femoral Adjustment in combination with each other â&#x20AC;&#x201C; applies genu valgum corrective force.

Design allows incremental application of corrective forces to maximize tolerance and final outcome with optimal patient compliance. Š Anatomical Concept, Inc. Phone: 800-837-3888

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Blounts KAFO How Does it Function?

Growth Adjustment Growth Adjustment â&#x20AC;&#x201C; shows lengthening adjustment via set screws to lengthen measurement from knee center to heel base. Note if lengthening is necessary to distance between knee center and proximal thigh, the medial and lateral set screws on the thigh cuff allow for this adjustment.

Design allows incremental application of corrective forces to maximize tolerance and final outcome with optimal patient compliance.

18

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Joint System and How Does it Function? The V-Vas joint system is a patented polycentric knee joint design with spherical bearings at each of the mechanical joint head axes. The ability for the joint to self align eliminates the time that would be normally spent realigning the mechanical joint and uprights. Thus, maintaining a smooth free motion action. This unique design allows the practitioner to provide an adjustable and gentle corrective force to the deformity. Adjustments can consist of a vara or valga angle adjustment of the tibia or femur independently, or varum or valgum angle adjustment of the knee. The degree of adjustment is dependent on the patientâ&#x20AC;&#x2122;s clinical and radiographic presentation. As the various adjustments are made, the V-Vasâ&#x201E;˘ joints accommodate the change in alignment through its self aligning abilities as seen in the photographs below.

Neutral

Tibia valga adjustment

Tibia and Femoral valgum adjustment

A simple free motion design for optimal compliance and outcomes!

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Physiologic Genu Valgum KAFO

Non Corrected

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Fully Corrected

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Hemiepiphysiodesis

KAFO

· Free motion · Posterior opening · · Linear adjustability · Post operative ·

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Bariatric KAFO

· Free motion · Valgum adjustable stress · · Simple linear adjustability · Improved compliance ·

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Bariatric KAFO

· Free motion · Varum adjustable stress · · Simple linear adjustability · Improved compliance · ©Anatomical Concept, Inc. Phone: 800-837-3888

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Bilateral Bariatric KAFO

· Free motion · Varum adjustable stress · · Simple linear adjustability · Improved compliance · © Anatomical Concept, Inc. Phone: 800-837-3888

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Low Profile KAFO

· Improved suspension · Posterior opening · · Linear adjustability · Free motion · © Anatomical Concept, Inc. Phone: 800-837-3888

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KAFO Step™Lock Joint

· Offset knee flexion weakness · · Adjustable offloading of medial · © Anatomical Concept, Inc. Phone: 800-837-3888

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K A FO

with PRAFO®

· Post operative · Fracture Management · · Anterior opening · Adjustable varum or valgum stress ·

©Anatomical Concept, Inc. Phone: 800-837-3888

www.AnatomicalConceptsInc.com Patent: 6,387,066 Fax: 800-657-7236 Email: Info@AnatomicalConceptsInc.com

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Functional KAFO

· Posterior thigh opening with Anterior calf opening · · Adjustable correction of genu valgum deformities ·

© Anatomical Concept, Inc. Phone: 800-837-3888

www.AnatomicalConceptsInc.com Patent: 6,387,066 Fax: 800-657-7236 Email: Info@AnatomicalConceptsInc.com 28


K A FO

Custom Shoe Attachment

· Ankle joint system of choice · · Adjustable offloading of genu valgum ·

©Anatomical Concept, Inc. Phone: 800-837-3888

www.AnatomicalConceptsInc.com Patent: 6,387,066 Fax: 800-657-7236 Email: Info@AnatomicalConceptsInc.com

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FIVE FUNCTION KNEE ORTHOSIS

1.

Drop Lock –

in full extension

FIVE FUNCTION KNEE ORTHOSIS

2.

Ratchet Lock –

3.

Range of Motion – infinite

The Pentagon™ is a posterior fitting, single upright knee orthoses that provides the orthopedic/rehabilitation team with a patient-friendly alternative to the traditional bulky double upright hinged knee configuration.

single release lever 15˚ increments

The double hinge orthoses are more difficult to utilize due to the sheer nature of the proper fitting standards. They are more time consuming to employ and more prone to cause additional follow up visits to address functional and comfort complications.

ROM adjustment in flexion and/or extension from 0˚ to 110˚

4.

Total Motion Lock – lock out in

Knee immobilizers are simple to use, but lack the joint control that is so often desired in the rehabilitation process. Other methods that utilize static attachment of the thigh and calf cuff to a posterior knee joint essentially cause the knee joint to misalign due to a friction moment.

any position

5.

Free Motion –

0˚ to 110˚

The Pentagon™ orthoses is the only system that allows the calf and thigh segments to dynamically shorten and lengthen with the patient’s extremity during flexion and extension of the knee.

 Free Motion

Cam Assembly

Rom settings will not be true if the settings are being checked with the Knee Orthosis off the patient’s extremity

Compensation for this shortening and lengthening is through the use of a free motion cam that is incorporated into the thigh and calf cuffs. With this unique feature comfort and function is achieved through out the full ROM of the knee orthosis. This design utilizes accurate alignment of the mechanical knee joint to that of the anatomical knee joint aiding in positive outcomes.

Also available in ROM-only version

This system design also allows for a simplified fitting of the knee orthoses. The unique Pentagon™ design can address up to five different knee orthoses functions: • • • • •

Drop Lock Knee Joint Ratchet Locking Knee Joint Range of Motion Knee Joint Total Motion Lock Free Motion Knee Joint

ROM-only version 1150-ROM –Adult 1050-ROM – Pediatric

The Pentagon™ Knee Orthoses is delivered ready to fit, with durable and highly adaptable soft goods to assure a simplified fitting experience. Each orthoses is provided with a supra-patella strap, a sub-patella strap and pads (the recommended application, as shown) A 4 pull knee cap can be provided upon request to meet the individual needs of you and your patient.

1150 – Adult, 1050 – Pediatric

Two Sizes Available – Adult and Pediatric

5,088,479 5,486,157 5,593,383 5,545,127

Patents 5,908,398 6,377,178 5,944,679 6,464,659 6,302,858 6,793,638 6,350,246 7,112,118

7,122,016 7,662,119 Patent Pending European Patent: EP 0 931 525 B1

1399 E. Western Reserve Road • Poland, Ohio 44514 Web: www.AnatomicalConceptsInc.com • Email: info@AnatomicalConceptsInc.com Toll Free: 1-800-837-3888 • Phone: (330) 757-3569 • Fax: 1-800-65PRAFO 6853

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ORT ORTHOSIS

Anatomical Concepts, Inc., is pleased to introduce the KMO® (Knee Management Orthosis), a COST EFFECTIVE patient friendly and simple approach to the orthotic management of the knee.

KMO® APPLICATION: s For an adjustable range of stabilization of the knee in the sagittal and/or the coronal plane as the patient’s conditions warrant s For pre and post operative management of bony and soft tissue injuries s Ideal for application following hamstring releases, ligament repairs, total knee arthroplasty, and chronic systemic conditions s For immediate prophylactic protection at end range until treatment plans are 950KMO® Adult 850KMO® Pediatric

950KMO® Adult 850KMO® Pediatric

950KMO® Adult 850KMO® Pediatric

950KMO® V/V Adult 850KMO® V/V Pediatric

Shown with optional stabilizing polyethylene shell.

Shown with optional stabilizing polyethylene shell.

EXTENSION Patent # 5,088,479 Patent # 5,486,157 Patent # 5,593,383 Patent # 5,545,127 Patent # 5,908,398 Patent # 5,944,679 Patent # 6,302,858 Patent # 6,350,246

Shown with optional stabilizing polyethylene shell.

FLEXION UP TO 110°

HEIGHT ADJUSTMENTS

(Additional ROM may be attained.)

18-24” Adult 13-17” Pediatric

Patent # 6,377,178 Patent # 6,464,659 Patent # 6,793,638 Patent # 7,112,118 Patent # 7,122,016 European Patent EP 0 931 525 B1 Patent Pending

VARUM/VALGUM ADJUSTMENTS ISO 9001:2000 REGISTERED

1399 E. Western Reserve Road s Poland, Ohio 44514-3250 800-837-3888 s Fax: 800-657-7236 s e-mail: ThePRAFO@aol.com s www.PRAFO.com

6070-7/17

© Anatomical Concept, Inc. Phone: 800-837-3888

Made with pride in the U.S.A.

www.AnatomicalConceptsInc.com Patent: 6,387,066 Fax: 800-657-7236 Email: Info@AnatomicalConceptsInc.com 31


KMO INFO KMO Measurements with Distal PKA segments Heel to Knee Center 850KMO with 550PKA/D/B

850KMO V/V with 550PKA/D/B

950KMO with 650PKA/APU/B

950KMO V/V with 650PKA/APU/B

Minimum 12.75" Maximum 15.5" Maximum 17.5"

Through Metal Holes Through Plastic Only

Minimum 13.5" Maximum 16.5" Maximum 18.5"

Through Metal Holes Through Plastic Only

Minimum 17" Maximum 22" Maximum 26"

Through Metal Holes Through Plastic Only

Minimum 18" Maximum 23" Maximum 27"

Through Metal Holes Through Plastic Only

KMO Liner Circumferences 850KMO and 850KMO V/V

Thigh Calf

12" to 20" Maximum 8" to 15" Maximum

950KMO and 950KMO V/V

Thigh Calf

15" to 30" Maximum 11" to 21" Maximum

Š Anatomical Concept, Inc. Phone: 800-837-3888

www.AnatomicalConceptsInc.com Patent: 6,387,066 Fax: 800-657-7236 Email: Info@AnatomicalConceptsInc.com

32


Š Anatomical Concept, Inc. Phone: 800-837-3888

www.AnatomicalConceptsInc.com Patent: 6,387,066 Fax: 800-657-7236 Email: Info@AnatomicalConceptsInc.com

33


Portfolio of V-VAS Applications