Compliant Limb Reconstruction: Co-engineering Body and Machine to Revolutionize Limb Salvage

顺应性肢体重建：身体和机器联合设计，彻底改变肢体抢救

• 批准号: 10473072
• 负责人: Tyler R Clites
• 金额: $ 140.4万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-10 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10473072
• 关键词: Amputation; Anatomy; Arthralgia; Award; Biological; Bionics; Clinical; Data; Disease; Engineering; Feasibility Studies; Foundations; Future; Goals; Human; Human body; Implant; Injury; Joints; Left; Limb Salvage; Limb structure; Link; Mechanics; Motion; Movement; Operative Surgical Procedures; Pain; Pathologic; Pathology; Patients; Performance; Procedures; Prosthesis; Quality of life; Research; Structure; Techniques; Tissues; Work; bone; design; disability; flexibility; functional restoration; human subject; implant design; innovation; mechanical behavior; mechanical properties; novel; prevent; programs; reconstruction; response

PROJECT SUMMARY My long-term goal is to reconstruct limbs that have lost function due to injury or disease. To achieve this goal, my research program combines surgical and mechanical design in a paradigm called anatomics, in which body and machine are co-engineered in pursuit of superior bionic performance. In this proposal, I apply an anatomics- centered approach to the surgical treatment of limb pathology. The human body is made up of compliant (“flexible”) structures that are fundamental to basic function. Joints, the highly-compliant structures that link bones together, are perhaps the most important of these structures for human movement. The nuanced relationships between load and deformation (called “compliance”) in joint tissues dictate how internal and external forces are converted to limb motion. Disruption of inherent biological compliance is often devastating to the body’s ability to move in a healthy way. This disruption can occur as a result of injury or disease, or even the reconstructive procedures intended to alleviate limb pathology. In severe cases, the pain and disability caused by changes to limb compliance are so intense, and treatment options so limited, that patients choose to amputate their viable but dysfunctional limb in search of relief. Unfortunately, there is currently no way to correct the compliance of biological joints and tissues when they are disrupted; this creates enormous challenges for the increasing number of patients with limb pathology, who are often left to live with limbs that are viable but non- functional. In response to this need, I propose a novel class of compliant implantable prostheses that would enable pathological joint compliance to be corrected, and function restored. With support from the New Innovator Award, I will advance a novel compliant limb reconstruction (CLR) pipeline capable of generating joint-and- pathology-specific implant mechanics, and apply this pipeline to design implants for two limb pathologies with urgent unmet clinical needs. I will then fabricate and validate these implants, collecting critical data to support early feasibility studies in human subjects. This work will form the foundation for future initiatives supporting refinement of the CLR pipeline, and is the first step toward a research program that uses the approach to target many different pathologies across all of the body’s joints. I expect that the proposed research will transform the clinical paradigm for treatment of limb pathology, opening the door to revolutionary new salvage options that alleviate pain, restore function, and prevent amputation.

项目摘要 我的长期目标是重建因受伤或疾病而失去功能的肢体。为了实现这一目标， 我的研究项目将外科手术和机械设计结合在一个称为解剖学的范例中， 和机器共同设计以追求上级仿生性能。在这个建议中，我应用了解剖学- 中心的方法，以外科治疗肢体病理。人体是由顺从的 （“灵活”）结构是基本功能的基础。关节，连接的高度柔顺的结构 骨骼结合在一起，也许是这些结构中对人类运动最重要的。细致入微的 关节组织中的载荷和变形（称为“顺应性”）之间的关系决定了内部和 外力被转换为肢体运动。固有生物学顺应性的破坏通常是毁灭性的， 身体以健康的方式运动的能力。这种破坏可能是由于受伤或疾病，甚至是 旨在减轻肢体病理的重建手术。在严重的情况下，疼痛和残疾造成的 由于肢体顺应性的变化如此强烈，治疗选择如此有限，患者选择截肢 他们能存活但功能失调的肢体来寻求解脱不幸的是，目前还没有办法纠正 当生物关节和组织被破坏时，它们的顺应性;这为生物关节和组织的发展带来了巨大的挑战。 越来越多的患者患有肢体病理学，他们通常只能带着有生命力但没有生命力的肢体生活。 不降低针对这一需求，我提出了一种新型的顺应性植入式假体， 使病理性关节顺应性得以纠正，功能得以恢复。在新创新者的支持下 奖，我将推进一种新的顺应性肢体重建（PIPE）管道，能够产生联合和- 病理学特定的植入物力学，并应用该管道设计两种肢体病理学的植入物， 未满足的临床需求。然后我将制造并验证这些植入物，收集关键数据以支持 在人类受试者中的早期可行性研究。这项工作将为今后的举措奠定基础， 这是对可持续发展管道的改进，也是朝着使用该方法瞄准的研究计划迈出的第一步。 身体的各个关节都有不同的病变我希望拟议的研究将改变 肢体病理治疗的临床范例，为革命性的新挽救方案打开了大门， 减轻疼痛，恢复功能，防止截肢。