U.S. Department of Veterans Affairs to fund new centre for advanced limb-loss research

Washington 16 December 2004Creating "biohybrid" limbs that use human tissue and space-age technology to assist amputees is the major goal of a $7,2 million grant by the Department of Veterans Affairs (VA) to establish a special research centre in Rhode Island. The five-year grant will fund the new Center for Restorative and Regenerative Medicine, to be operated jointly by the Providence VA Medical Center, Brown University and the Massachusetts Institute of Technology (MIT).

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"Helping our combat-disabled veterans recover from their wounds is among VA's highest responsibilities", stated Secretary of Veterans Affairs Anthony J. Principi. "This grant allows us to bring cutting-edge science to help these wounded heroes."

Scientists hope to create "biohybrid" limbs that will use regenerated tissue, lengthened bone, titanium prosthetics and implantable sensors that allow amputees to use nerves and brain signals to move arms or legs. The aim is to give amputees, particularly war veterans, better mobility and control of their limbs and to reduce the discomfort and infections common with current prosthetics.

According to a recent Senate report, body armour and improvements in casualty care have contributed to the lowest "died-of-wounds" rate in military history. However, the report says more surviving soldiers from the Iraq war have lost arms or legs. Historically, 3 percent of soldiers wounded in action required some amputation, but the number in Iraq is 6 percent, according to the report.

"VA has been a leader in prosthetics and limb-loss research throughout its history", stated Dr. Jonathan B. Perlin, VA's acting under secretary for health. "This new centre continues that tradition. It will help veterans and all Americans who have lost limbs to have greater mobility, greater function and greater independence than previously possible."

The new research centre will be located at the Providence VA Medical Center. Research and clinical care will take place at the medical centre, Brown, MIT and Rhode Island Hospital. Dr. Roy Aaron, director of the centre at VA Providence, stated that biohybrid limbs will maximize amputees' existing tissue and bone. Surgery that lengthens bone will be coupled with tissue engineering techniques to speed healing. The goal is to make bones longer to improve the fit of prosthetics and make bones stronger to reduce fractures.

Researchers will use tissue engineering to further restore limbs. Research also will focus on joining biological tissue with high-tech prosthetics. Researchers will try to improve a process known as "osseo-integration", in which a titanium bolt is attached to an amputee's existing limb, allowing the attachment of prosthetics. These researchers will try to grow skin that will fuse with the titanium, forming a natural seal around the bolts to reduce the rate of infection.

"While many of the techniques we're using are being tested across the country, this project marks the first time they will be pulled together to improve care for amputees, particularly veterans", Dr. Aaron stated. Anyone who has lost a limb, due to injuries or diseases such as diabetes and bone cancer, will be eligible to enroll in clinical trials.

While the project's ultimate aim is to build biohybrid limbs, experiments may yield advances that could be used for many clinical applications. For example, cartilage regeneration could prevent the need for total knee and hip replacement surgeries. A skin seal could improve the safety of catheters, stents and other medical devices prone to infection. And robotic knees and ankles could help people immobilized by stroke, cerebral palsy and multiple sclerosis.


Leslie Versweyveld

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