Acknowledging the need for a greater understanding of
heterotopic ossification (HO), the Department of Defense
awarded Carnegie Mellon University’s Bone Tissue Engineering Center a
3-year, $2.9 million research grant that is aimed at developing a therapy for
the prevention of these prevalent bone formations.
|Jeffrey O. Hollinger|
According to Jeffrey O. Hollinger, PhD, director of the Bone Tissue
Engineering Center, Carnegie Mellon University, HO occurs when bone nodules
form in the muscle tissue at the amputation site. Amputees suffer great pain as
a result of the bone formation at the residual limb. Also, it is difficult to
properly don a prosthesis due to the formation of the bone nodules. Hollinger,
along with co-principal investigator, Krzysztof Matyjaszewski, PhD, J.C. Warner
professor of natural sciences, Carnegie Mellon University’s Mellon College
of Science, plan to develop nanostructured polymers that will block the bone
formation in the patient’s residual limb.
“What we are proposing is to develop a therapy that we can use at
the time the surgeon is treating the amputation site so that these little bony
nodules do not form in the muscle,” Hollinger told O&P Business
News. “The therapy focuses on prevention. HO seems to be a relatively
prevalent pathology that is associated with combat trauma.”
Amputations among wounded soldiers increased more than 60%, from 47
incidents in 2009 to 77 incidents through Sept. 23, 2010, according to U.S.
Army reports. The foremost causes of amputations for soldiers are injuries from
improvised explosive devices. According to Hollinger, the wounded soldiers in
Iraq and Afghanistan seem to be at a high risk for developing HO following the
loss of a limb. Along with the pain and inability to properly don a prosthesis,
HO is a potential source of infection and can severely compromise the
patient’s function, mobility and quality of life.
According to Hollinger, while prevalent in combative conditions, HO,
which is more commonly found in the lower extremity, but can be diagnosed for
upper extremity amputees as well, can also be widespread in non-combat
scenarios where patients are receiving total hip prostheses. The ramifications
of this research goes beyond just military trauma medicine, Hollinger
explained, and may significantly impact how the civilian sector is treated for
hip, knee or even shoulder prostheses.
Hollinger does concede that the mechanism for HO is not truly known, but
the combination of orthopedic and central nervous system (CNS) trauma results
in the nodules of bone at the amputation site. As of press time, Hollinger
explained that the center has conducted modest research. When the funds are
made available, they will launch the program, he said.
“With these traumatic episodes that result in a loss of a limb,
there is also CNS trauma,” Hollinger said. “The combination of the
CNS trauma with the loss of a limb seems to result in a signaling cascade in
that muscle tissue at the amputation site that results in bone formation.”
— by Anthony Calabro
Disclosure: Jeffrey Hollinger has no
relevant financial disclosures.
The U.S. Department of Defense research into O&P areas has occurred
over the decade and they have been helpful in innovating the industry. I think
it is wonderful that they are doing what they are doing.
There is certainly a need to get some of the Department of Defense
research to market right away, but we also need to have some long-term studies
like this one to show the efficacy of research as well. The days of doing
research because it is interesting are gone. Enter the days when research needs
to be relevant. By relevant, I mean relevant and applicable today. With the
high cost of technology, the research must be justified from a medical
necessity standpoint. It has to have the ability to improve somebody’s
life and at the same time, reduce the overall costs of treatment.
— Brian Gustin, CPO
Prosthetics and Orthotics
Disclosure: Brian Gustin has no relevant