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: 10261509
• 负责人: Dustin L. Crouch
• 金额: $ 31.85万
• 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 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10261509
• 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; 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; 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; 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 支架翻译项目的长期目标是与With一起改善感觉运动量。 截肢和其他严重的肌肉缺陷。 恢复自然运动和感觉功能，因为所有假体必须在您身上磨损 身体，先前的方法需要转移肌肉福克斯福克斯的皮肤，这有局限性的功能 和外观。 内生物是可以在生命皮肤中植入的肢体肢体假体 几何特性和机械性能可能会有所不同 内植物可能会在不同时间植入各个临床casses的不同时间。 了解内部主体和肌肉重新安装时间如何影响肌肉结构和运动 功能。 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） 膝盖截肢的兔子模型中的结构和运动功能。 肌肉结构和运动功能将在内部主体中延迟重新计时恢复 脚踝，但最好在生物踝关节上重新装饰。 研究是，它将使用主要的重要体内数据来支持userch并告知howm howm howm howm howm如何如何 临床上实施内寄生虫。 重新计时时间对生物肢体环境中肌肉结构和运动功能的影响，并且（AIM 2） 确定肌肉重新手段的影响 和第2阶段的运动功能。 用更换兔子后肢脚踝和脚的内path病，残留的肢体中的肌肉将是 使用合成肌腱连接到内主踝关节。 超声成像，组织测量和组织学。 在移动和脚踝产生脚踝生物力学期间的后肢生物力学在电刺激期间 附着的肌肉与拟议研究的预期结果 体内实验平台 - MDE原型和动物模型 - 肌肉结构和运动的数据 不同的重新调节时间和上下文的功能。 与巨大的肢体假肢完全不同。 将增强感觉运动功能，并使肢体假体更具吸引力，舒适和方便 使用，大大改善患者的独立性和生活质量。