the subject matter described herein may take form in a variety of embodiments , including but not limited to , the embodiments , components , arrangements of components , assembly methods and arrangements of methods , and apparatus usage procedures , and arrangements of procedures as described below . the embodiments described , while possibly being preferred embodiments , are illustrative examples and are not meant to limit the invention described herein . the apparatus includes an implantable element configured for direct attachment to a bone mass . some examples of existing components that could serve as the implantable element include bone pins , bone screws , bone plates , intramedullary rods , spinal fusion rods , pedicle screws or any other implant grade device approved for direct contact with bone . alternatively , the implantable element could take form in new custom arrangements suitable for direct attachment to a bone mass . in fig1 a the implantable element is illustrated as a bone screw 10 . bone screws of this type are commonly used to stabilize fractures and / or secure implants such as plates or rods . the apparatus requires that the implantable element include magnetic properties . in fig1 a for example , the bone screw 10 could be fabricated from a magnetic grade stainless steel . most implantable grade materials however are not magnetic . fig1 b illustrates an embodiment of a bone screw that includes a magnetic material 11 captured within the screw body . since magnetic materials are generally not biocompatible , this embodiment traps and seals the magnetic material 11 within the screw body . a cavity cover 12 , fabricated from an implantable grade biocompatible material , can be utilized to hermetically seal the magnetic material 11 to and / or within the implantable element . the magnetic material 11 , for example could be iron , nickel , cobalt or various other materials with magnetic properties . in another embodiment a permanent magnet could also be used as the magnetic material . in this manner , a bone screw fabricated from the typically used implant grade materials , for example non - magnetic stainless steel or titanium , could contain a magnet material embedded and sealed within its body , so as to present no biocompatibility concerns . bone screws are common to many orthopedic repair procedures , and therefore could provide convenient , practical means for delivering forces to various areas of the skeletal frame . furthermore , bone screws also can be safely removed at a later time . for example in some instances it may be specifically desirable to remove the magnetic bone screw for mri compatibility . in alternative embodiments , a , similar approach of embedding and sealing a magnetic material within an implantable element could take form in components such as bone pins , bone plates , intramedullary rods , pedicle screws , and transverse connectors . the apparatus also includes an external force generator that can be worn or placed externally in the vicinity of the implantable element . when the apparatus is activated , the force generator operates in cooperation with the implantable element to transmit forces into a desired bone mass . fig2 illustrates a tibial shaft fracture stabilized by an intramedullary rod 15 . the apparatus delivers dynamic forces to the fracture site to stimulate and accelerate the repair process . as illustrated in fig2 , an external force generator 20 includes a permanent magnet 21 configured for movement a ′. permanent magnet 21 is surrounded by windings 22 . drive electronics 23 commutate the windings to induce rotational movement of the permanent magnet 21 . in this manner , the permanent magnet acts as its own motor , rather than requiring some form of additional driver / motor hardware to initiate magnet motion . as the permanent magnet moves , it imparts a dynamic magnetic field on the magnetic material in the bone screw 10 , whereby forces are generated and transmitted into the bone mass . in fig2 , the forces are transmitted through bone screw 10 to the remote fracture site . the force generator 20 embodiment illustrated in fig2 is a unique design . for home health care scenarios where the patient is operating the apparatus to administer force therapy , it &# 39 ; s important to have a cost effective , small , portable , and easy to operate architecture , among other things . furthermore , the existing classes of bone stimulators are indicated as a secondary treatment option , for a bone injury that is not healing properly on its own . this indication is , in part , due to the excessive cost of the devices . the inventive nature of the fig2 embodiment is partially aimed at cost efficiency to enable prescription of the technology as part of the mainline bone repair treatment . the modern healthcare environment requires , in general , that new devices present cost savings opportunities to reduce the overall burden on the health care industry . the force generator embodiment in fig2 is an inventively simple design that includes basic motor drive electronics , magnet wire wrapped around a permanent magnet to create windings , and an enclosure to contain the components and orient the force delivery . in another embodiment illustrated in fig3 a , an electromagnet is utilized in conjunction with drive electronics 23 to generate the dynamic magnetic field . when the force generator 20 is placed in the vicinity of bone screw 10 , the magnetic field of electromagnet 30 and magnetic material 11 will interact , thereby generating force . the electromagnet could be cycled on / off to deliver dynamic force pulses to the bone , or various other dynamic arrangements . there may be benefits in delivering multiple force vectors to the bone area in need of repair . as such , alternating the direction of current flow 31 through electromagnet 30 could alternate . as current flow direction 31 alternates , north pole 32 and south pole 33 also alternate . the resulting force pulses would include force application in various opposing directions based on attractive and repelling interaction between the switching poles of the electromagnet 30 and the implantable element 10 . electromagnets suitable to penetrate subcutaneous tissue distances to impart forces on the implantable element tend to be expensive , large , and heavy . in another embodiment as illustrated in fig3 b , additional drive hardware in the form of an electric motor 35 is coupled to the permanent magnet 21 to impart motion . for example , drive motor 35 could be operably connected to permanent magnet 21 to rotate the magnet about axis a ″, thereby imparting a dynamic magnetic field on the adjacent magnetic material 11 included with the implantable element 10 . in delivering dynamic forces to a remote bone area in need of repair , the external force generator operates in cooperation with the implantable element to establish the magnitude and frequency of force application . a further inventive nature of the apparatus includes various provisions for controlling the direction of force application . fig4 a illustrates a bone screw 10 that includes a permanent magnet with poles oriented perpendicular to the screw axis b ′. fig4 b illustrates another embodiment in which the bone screw 10 includes an alternative permanent magnet with its poles also oriented perpendicular to the screw axis b ′. fig5 a illustrates a cylindrical permanent magnet 21 that is diametrically magnetized . in fig5 b , the diametrically magnetized permanent magnet 21 is operably mounted within the external force generator 20 . the force generator 20 includes an alignment feature 25 that positions and orients the force generator with respect to the implantable element of the apparatus . in fig5 b , the implantable element is a bone screw 10 . fig5 c is a detailed view of fig5 b illustrating the bone screw 10 with an embedded permanent magnet 11 whose poles are aligned substantially parallel with the axis of the tibia bone c ′. the alignment feature 25 on the force generator 20 positions the rotating magnet 21 offset below the bone screw . in this orientation , the apparatus will deliver forces to the fracture site that are substantially in line with the axis of the tibia c ′ as indicated by force direction arrow 26 . such compressive forces at the fracture site have shown to be beneficial to the fracture healing process . in fig5 d and 5e , the bone screw 10 has an embedded permanent magnet whose poles are aligned substantially parallel with the axis b ′ of the screw , and an external force generator 20 whose rotating permanent magnet 21 is aligned substantially coplanar with the screw . in this embodiment , the apparatus will deliver substantially shear type forces , as indicated by force direction arrow 26 , to the fracture site . shear forces at the fracture site are known to be less desirable , and even detrimental to stimulating bone repair at the fracture site . in these various inventive arrangements , the apparatus provides directionally controlled force delivery capabilities . fig6 is another embodiment in which the implantable element 10 includes a feature , such as a screw head 17 , positioned subcutaneous . placing a portion of the implantable element in the subcutaneous space allows the implantable element to be easily located , for example by directly palpating the soft tissue 18 . successfully locating the implantable element allows for proper alignment and delivery of forces . furthermore , the subcutaneous positioning minimizes the distance between the external force generator and the implantable element . minimizing this distance is critical to accuracy of force delivery , overall cost of the apparatus , and patient safety . for example , a large separation distance between the implantable element and the external force generator would require a much stronger magnetic field . a stronger magnetic field can cost exponentially more to facilitate , presents inherent dangers for the patient , and reduces precision of force control . in the fig6 embodiment , the external force generator 20 includes a mating receptacle 28 that engages and aligns over the screw head 17 , thereby establishing the direction of force delivery . the external force generator may additionally include tissue compression features 27 . the tissue compression feature 27 can further assist in aligning the external force generator 20 to the implantable element . furthermore , the tissue compression feature ( s ) 27 compresses the soft tissue around the implantable element , thereby allowing the permanent magnet 21 to be positioned closer to the implantable element for more efficient and controlled force delivery . fig7 illustrates a force delivery apparatus for delivering dynamic forces to a vertebral disc space to promote and accelerate spinal fusion . in spinal fusion procedures , the disc space 40 where the bone fusion is to occur is a remote location that would require significant risks and complexities to directly couple and apply force . fig7 illustrates an embodiment in which forces can be transmitted into the disk space 40 by coupling with nearby generally healthy bone mass to transmit forces into the remote disc space 40 . in the fig7 embodiment , the implantable element is pedicle screw 41 that includes a permanent magnet 11 with north pole 45 and south pole 46 aligned vertically . the external force generator includes a rotating permanent magnet 21 located slightly offset below the pedicle screw &# 39 ; s axis y ′. this arrangement emphasizes compressive forces on the disc space 40 to stimulate and accelerate the bone fusion . the fig7 embodiment provides further illustrative example of the inventive nature in which the apparatus manages magnitude and direction of force delivery to a remote bone location . fig8 a illustrates a commercial embodiment of an external force generator 20 attached to a leg in a preferred orientation for delivering forces to a tibia fracture . the force generator 20 includes a mating receptacle 28 that engages and aligns over the implantable element . in this embodiment , alignment receptacles 28 are located on two opposing faces of the force generator , thereby making the apparatus ambidextrous for use on either left or right tibia . the external force generator includes straps 29 that attach the external force generator to the leg . the strap attachment provisions 29 , along with the alignment receptacle 28 , positions the apparatus for directional control of force delivery to the tibia fracture site . fig8 b illustrates a commercial embodiment of an external force generator with one half of the enclosure open to illustrate the internal components . the apparatus includes a permanent magnet 21 that can rotate about axis a ′. the permanent magnet 21 is a diametrically magnetized cylindrical magnet with north 32 and south 33 poles illustrated . the magnet 21 is operably mounted to shaft 36 and bearings 37 . winding 22 wraps around the permanent magnet 21 , drive electronics 23 to energize and commutate the windings 22 to induce rotational magnet motion about axis a ′. the permanent magnet 21 is operably mounted within the enclosure of the apparatus and between the alignment receptacles 28 . the apparatus also includes an alignment led 38 . in this embodiment , the drive electronics 23 illuminate the led 38 when the alignment receptacle 28 and permanent magnet 21 are in desirable position for force delivery with respect to the implantable element . this is accomplished through magnetic field strength sensors that are incorporated with the drive electronics 23 . the drive electronics are also configured to establish the frequency of applied force , as well as duration . research indicates bone cells can become oversaturated by stimulus within a short duration of 20 minutes or less . additional stimulation beyond saturation point is not necessarily beneficial ; therefore , the drive electronics automatically shut down the device after a prescribed amount of time . this avoids over stimulating the bone .
an orthopedic device delivers dynamic forces to a desired remote bone region . dynamically arranged mechanical forces are known to stimulate bone cells . the device includes an implantable element configured to couple with a generally accessible and healthy bone area , from which location it &# 39 ; s configured to transmit forces to a remote bone area in need of repair , regrowth , or regeneration . further , the device positions and orients the implantable element where it can be readily acted on by the device &# 39 ; s force generator . the force generator is configured to impart dynamic forces that are transmitted through the implantable element and into a desired bone mass including a remote bone area in need of repair . this device promotes fracture healing , treats osteoporotic or other poor quality bone , and promotes vertebral fusion in conjunction with a spinal fusion procedure .