Ushering in the Next Generation of Prosthetics

VA clinicians must be trained on each new piece of prosthetic technology that is offered to veterans — technology that in many cases has been developed with help from VA and DoD. The two agencies work together with private industry and other agencies, including DARPA and the U.S. Army’s Medical Research And Materiel Command to determine where the needs are in terms of prosthetics and to put forth requests for proposals.

One of the biggest projects to arise out of this partnership was DARPA’s upper-extremity program that resulted in the Skywalker prosthetic arm. “This project started with a group from Walter Reed and VA identifying needs that we thought were lacking in the current technology,” Miller says.

VA currently has a project underway through its Innovation Initiative (VAi2) looking into new technologies related to prosthetics’ sockets. “This is a need that was identified several years ago. Patients perspire in sockets, there’s a lot of volume change, and the suspension is not where we want it to be,” Miller says. “VA is currently funding some SBIR grants for those projects.”

What VA would like to see in the near future is an auto-adaptive socket — either a socket made from new materials that prevent perspiration or that allows for cushioning and size change in the limb, or a truly shape-changing socket. VAi2 is still in the grant review process, but Miller expects the awards for new socket technology proposals to be released in the next few months.

“There are a number of technologies that have been commercialized and are out on the market — a lot of things that were identified by looking at needs in the private sector and in our patients and that the typical manufacturer could not have designed alone, either through lack of funding or lack of expertise,” Miller explains. “These projects forced groups to work together to develop the best prosthetic technology.”

Newer technology also requires more research dollars, Miller notes.  Advanced technology and next-generation materials mean a more-expensive product and a more expensive research process. “The challenge in the future is whether research dollars will continue to be there to fund these new projects,” he said. “And then there’s the marketization of these projects. We don’t want them to be science projects sitting on a shelf.”