FOURCEPOINT ™ HINGE How the FourcePoint ™ Hinge keeps the knee out of the “at risk” position Aggressive eccentric contractions of the quadriceps produce significant anterior tibial translation and can injure the ACL or permanently stretch out an ACL graft 22 . Quadriceps-intensive activities should be avoided at joint angles where strains are at a maximum, particularly the last 30 degrees of extension. DJO has developed a hinge to address maximising ACL and ACL graft protection in these “at risk” positions. Small knee flexion angles at initial contact during landing tasks may contribute to ACL injuries. The FourcePoint Hinge can be used to control joint range-of-motion by increasing the knee flexion angle during landing, resulting in a decrease of anterior shear force on the ACL by 9-13% 23 .
Flexion
Extension
The DonJoy FourcePoint™ utilises a leaf spring mechanism in the hinge to apply gradually increasing resistance during knee extension. The resistance engages in the last 25 degrees of extension (relative to the extension stop). The hinge has three levels of resistance with the option to turn off resistance if appropriate.
The DonJoy Fourcepoint ™ utilises a leaf spring system in the hinge
The resistance serves three critical roles: • First, it reduces the time spent near full extension or in the “at risk” position. • Second, it gradually adds posterior load to the tibia complementing the 4-Point-of-Leverage in preventing anterior tibial translation. • Third, it eliminates the extension shock felt when a patient extends into a 10 degree standard rigid stop.
FourcePoint Hinge Technology works to enhance DonJoy’s 4-Point-of-Leverage design by damping knee joint extension, which improves the mechanical performance of the brace and reduces shear forces at the knee.
The FourcePoint hinge combined with the 4-Point-of-Leverage cuff and strapping design provides a more comfortable brace that reduces anterior shear forces at the knee, providing protection to the healing graft in ACL reconstructed patients, stability to an unstable knee in ACL deficient persons, and prophylaxis during sports activities.
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