Muscle-driven, implanted endoprostheses for musculoskeletal limb reconstruction

用于肌肉骨骼肢体重建的肌肉驱动植入式内置假体

• 批准号: 10829993
• 负责人: Dustin L. Crouch
• 金额: $ 33.17万
• 依托单位: UNIVERSITY OF TENNESSEE KNOXVILLE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-11 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10829993
• 关键词: Affect; Amputation; Anatomy; Animal Model; Ankle; Appearance; Articular Range of Motion; Artificial Implants; Behavior; Biological; Biomechanics; Clinical; Conceptions; Data; Defect; Devices; Electric Stimulation; Esthesia; Flexor; Future; Geometry; Goals; Hindlimb; Histology; Immobilization; Impairment; Implant; Joints; Knee; Knowledge; Life; Limb Prosthesis; Limb structure; Locomotion; Measurement; Measures; Mechanics; Mission; Modeling; Motor; Movement; Muscle; Musculoskeletal; Musculoskeletal Diseases; National Institute of Arthritis, and Musculoskeletal, and Skin Diseases; Operative Surgical Procedures; Orthopedics; Oryctolagus cuniculus; Outcome; Output; Patients; Persons; Phase; Prosthesis; Public Health; Quality of life; Recommendation; Recovery; Recovery of Function; Research; Research Support; Residual state; Sensorimotor functions; Sensory; Skin; Technology; Tendon structure; Testing; Time; Tissues; Triceps Brachii Muscle; Ultrasonography; bone; clinical translation; experimental study; foot; functional outcomes; high reward; high risk; implantation; improved; in vivo; innovation; mechanical properties; muscle degeneration; muscular structure; novel; prevent; prototype; reconstruction; research and development; residual limb; tibialis anterior muscle

PROJECT SUMMARY The long-term goal of the proposed translational project is to improve the sensorimotor function of people with amputation and other severe musculoskeletal defects. Physically attaching muscles to limb prostheses could restore natural motor and sensory function to patients. Since all prostheses must be worn externally on the body, the previous approach required transferring muscle forces through skin, which had limitations in function and appearance. To better facilitate physical muscle-prosthesis attachment, the proposed project introduces endoprostheses, which are jointed limb prostheses that can be completely implanted within living skin. The geometry and mechanical properties will likely differ between endoprosthetic and biological limbs, and endoprostheses may be implanted at different times across clinical cases. There is an urgent need to understand how the endoprosthesis and muscle reattachment timing affect muscle structure and motor function. The overall objective of the proposed project is to determine the effects and interactions of muscle reattachment timing (immediate vs delayed) and context (biological vs endoprosthetic limb) on muscle structure and motor function in a rabbit model of below-knee amputation. The project’s central hypothesis is that muscle structure and motor function will recover with delayed reattachment across an endoprosthetic ankle but will be best when reattached immediately across a biological ankle. The rationale for the proposed research is that it will provide critical in vivo data to support our future research and inform how endoprostheses are implemented clinically. Phase 1 of the project includes two aims: (Aim 1) quantify the effect of reattachment timing on muscle structure and motor function in a biological limb context, and (Aim 2) determine the effect of muscle reattachment context (biological vs endoprosthetic limb) on muscle structure and motor function. In Phase 2, Aim 3 is to evaluate the interaction effect of reattachment timing and context. The endoprosthesis will replace the rabbit hindlimb ankle and foot, and muscles in the residual limb will be attached across the endoprosthetic ankle using synthetic tendon. Muscle structure will be measured by ultrasound imaging, tissue measurements, and histology. Motor function will be assessed by measuring hindlimb biomechanics during locomotion and ankle force-generating capacity during electrical stimulation of muscles attached to the endoprosthesis. The expected outcomes of the proposed research are a working in vivo experimental platform – an MDE prototype and animal model – data on muscle structure and motor function for different reattachment timings and contexts. The endoprostheses concept is highly innovative and radically different from existing externally worn limb prostheses. Endoprostheses are significant because they will enhance sensorimotor function and make limb prostheses more attractive, comfortable, and convenient to use, drastically improving patients’ independence and quality of life.

项目摘要 拟议的翻译项目的长期目标是提高患者的感官功能 截肢和其他严重的肌肉骨骼缺陷。将肌肉固定在肢体假肢上 恢复患者的天然运动和感觉功能。由于所有假肢必须外部磨损 身体，先前的方法需要通过皮肤转移肌肉力，这有局限性的功能 和外观。为了更好地促进物理肌肉主张的依恋，拟议的项目介绍了 内生物是可以完全植入生命皮肤的连接肢体假体。这 几何特性和机械性能可能会有所不同 在临床病例中，可以在不同时间植入内寄生虫。迫切需要 了解内部主体和肌肉保留时间如何影响肌肉结构和运动 功能。拟议项目的总体目的是确定肌肉的影响和相互作用 肌肉上的重新计时时间（立即与延迟）和上下文（生物主体肢体） 膝盖截肢的兔模型中的结构和运动功能。该项目的中心假设是 肌肉结构和运动功能将恢复，延迟的内主人假定 脚踝，但是当立即跨过生物脚踝时，将是最好的。提议的理由 研究是，它将提供关键的体内数据，以支持我们的未来研究并告知如何 内寄生虫在临床上实施。项目的第1阶段包括两个目的：（目标1）量化 放置时机对生物肢体环境中肌肉结构和运动功能的影响，以及（AIM 2） 确定肌肉保留环境（生物学与内主四肢）对肌肉结构的影响 和运动功能。在第2阶段，AIM 3是评估扩展时间和环境的相互作用效果。 内章将取代兔子后肢脚踝和脚，残留肢体中的肌肉将是 使用合成肌腱连接到内主踝关节。肌肉结构将通过 超声成像，组织测量和组织学。运动功能将通过测量评估 在移动和踝部力量产生能力期间，后肢生物力学在电刺激期间 肌肉附着于内部假体上。拟议研究的预期结果是 体内实验平台 - MDE原型和动物模型 - 肌肉结构和运动的数据 用于不同保留时间和上下文的功能。内胎概念具有很高的创新性，并且 与现有的外部肢体假体完全不同。内植物很重要，因为它们 将增强感觉运动功能，并使肢体假肢更具吸引力，舒适和方便 使用，大大改善患者的独立性和生活质量。

项目成果

Replacement of tibialis cranialis tendon with polyester, silicone-coated artificial tendon preserves biomechanical function in rabbits compared to tendon excision only.

• DOI: 10.1186/s13018-024-04581-7
• 发表时间: 2024-02-02
• 期刊: Journal of orthopaedic surgery and research
• 影响因子: 2.6
• 作者: Easton KL;Hatch C;Stephens K;Marler D;Fidelis O;Sun X;Bowers KM;Billings C;Greenacre CB;Anderson DE;Crouch DL
• 通讯作者: Crouch DL