United States Department of Veterans Affairs
VA Center of Excellence for Limb Loss Prevention and Prosthetic Engineering

Recent Events

Ankle Arthrodesis versus Arthroplasty


Top: Foot markers on a model used for gait simulation in laboratory testing. Bottom: Front and side images of an ankle joint replacement.

Top: foot markers on a model used for gait simulation in laboratory testing. Bottom: front and side images of an ankle joint replacement.

Center Director Dr Bruce Sangeorzan has been working in the field of ankle osteoarthritis since the early 1990s and is only too familiar with the agony suffered by so many Veterans, often under traumatic circumstances: “Although injury and arthritis contribute less than many other afflictions to mortality, they contribute more to disability,” he comments. “In particular, the number of years for which people are affected are very high for trauma because it affects younger people. I believe that both arthritis and trauma rank in the top 10 for impact on the American population.”

Dr Sangeorzan’s cutting-edge research on arthrodesis and arthroplasty for end-stage ankle arthritis is making exciting progress in limb loss prevention. The comparison between arthrodesis – traditionally considered the ‘gold standard’ of treatment – and arthroplasty has provided vital insight into the efficacy of each option in terms of both physical and psychological gains.

In addition to the physical benefits described by increased step activity in both arthrodesis and arthroplasty patients, Dr Sangeorzan was able to identify some pre-operative baseline differences between patients undergoing arthrodesis and arthroplasty which could enhance surgical decision making and aid in the assessment of postsurgical treatment efficacy. Findings from the ongoing study indicate self reported pain reduction and improved gait function after surgery for both treatments.

Dr. Bruce Sangeorzan’s research was featured in the latest issue of International Innovation. International Innovation, published by Research Media, is the leading global dissemination resource for the wider scientific, technology and research communities,dedicated to disseminating the latest science, research and technological innovations on a global level. More information and a complimentary subscription offer to the publication publication can be found at: www.researchmedia.eu

Link to the article: Ankle Arthrodesis versus Arthroplasty


VA Secretary and U.S. Senator Visit the Center of Excellence


Dr. Klute & Secretary Shinseki discuss the CESR, worn by Veteran amputee Mr. Will Silva.

Dr. Klute & Secretary Shinseki discuss the CESR, worn by Veteran amputee Mr. Will Silva.

The VA Center of Excellence for Limb Loss Prevention and Prosthetic Engineering in Seattle, WA, was pleased to host Secretary of Veterans Affairs, Mr. Eric Shinseki, on June 1, 2011, and Senator Patty Murray (D-WA) on April 29, 2011. Senator Murray is the chair of the U.S. Senate Committee on Veterans’ Affairs. Joseph Czerniecki MD, the Associate Director of the Center, coordinated these fact-finding visits, along with Jeri Rowe of the public affairs office.

During the visits, Dr. Glenn Klute spoke about recent advances in prosthetic engineering, such as the Controlled Energy Storage and Release Foot (CESR). The CESR foot is a collaborative development effort between the Seattle VA and Dr. Art Kuo at the University of Michigan. The CESR foot is unique because it stores energy when the foot contacts the ground and releases it later to assist with propulsion. Mr. Will Silva, a Veteran amputee, demonstrated the use of the CESR foot. He said the CESR foot is “not as tiring” as a regular prosthetic foot, and “it gives you a push when you walk.” Dr. William Ledoux also spoke with Senator Murray and Secretary Shinseki. He described his efforts to develop a 3D x-ray system that tracks the motion of individual foot bones. This system can be used to study bone motion and differences in how the tissues of the foot deform in healthy patients compared to diabetic dysvascular patients who are at increased risk for foot ulcers.

A transfemoral amputee

Dr. Klute & Senator Murray discuss the CESR, worn by Veteran amputee Mr. Will Silva.

Senator Murray praised the “amazing research” at the Center, and she commended Mr. Silva for his willingness to help other Veteran amputees by participating as a research subject in the Center’s studies.  Secretary Shinseki also voiced his support for the Center’s research. He praised the technological advances, such as the CESR foot, that allow amputees to walk farther with less effort, and he suggested that future research should consider how the entire foot contributes to propulsion, in addition to the ankle. The focus of the Seattle RR&D Center is on better understanding the function of the lower limb, preserving that function after injury or disease, and restoring function after limb loss through better treatment and prosthetics.