PROVIDENCE – A Providence-based research team has launched $7.2-million project financed by the U.S. Department of Veteran Affairs to develop better ways to restore arm and leg function to amputees, including many returning from the war in Iraq.
The multidisciplinary team includes the Providence Veterans Affairs Medical Center, Brown University and the Massachusetts Institute of Technology. The scientists’ ultimate goal is to create “biohybrid” limbs that will use regenerated tissue, lengthened bone, titanium prosthetics and implantable sensors that allow an amputee to use nerves and brain signals to move the arm or leg. They hope to give amputees better mobility and control of their limbs and reduce the discomfort and infections common with current prosthetics.
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According to a U.S. Senate report, body armor and improvements in combat casualty care have contributed to the lowest “died of wounds” rate in recorded military history. But even though they survive their injuries, many soldiers are losing arms and legs. While historically, 3 percent of soldiers wounded in action required some amputation, the rate has grown to 6 percent in Iraq, according to the report. The Walter Reed Army Medical Center in Washington, D.C. has treated more than 200 soldiers who have lost one or more limbs in Iraq.
Dr. Roy Aaron, professor of orthopaedics at Brown Medical School and attending physician at Rhode Island Hospital and The Miriam Hospital, will lead the Providence project, serving as director of the new Center for Restorative and Regenerative Medicine.
Aaron will oversee nine investigators at Brown and one at MIT. All have research appointments at the Providence VA. Together, the team has expertise in orthopaedic surgery, physical rehabilitation, community health, tissue engineering, neuroscience, artificial intelligence, robotics and materials science.
Research and clinical care will take place at the Providence VA Medical Center, Brown, MIT and Rhode Island Hospital.
Aaron said 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. For example, one group will encapsulate time-release growth factors to inject into damaged joints along with precursor cartilage cells and supporting material such as collagen to try to regenerate the shock-absorbing tissue and save elbows and knees.
In addition, the researchers will look at ways to join biological tissue with high-tech prosthetics.
“Advances in tissue engineering, robotics and neuroscience put many of our goals within reach,” Aaron said. “While many of the tools and 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.”
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.
