Faculty Highlight: Where Technology Meets Patient Care

Faculty & Alumni Highlight: Bo Foreman and Bart Gillespie WHERE TECHNOLOGY MEETS PATIENT CARE

Bo Foreman and family

Bart Gillespie and family Although distinguished in their own individual pursuits, the collaboration between Bo Foreman, PT, PhD, faculty member and class of 1994 and Bart Gillespie, PT, DPT class of 2002 is showing signs of being even more significant to the amputation community that has come to define so much of their work and research.

Dr. Foreman first studied engineering, but soon switched to physical therapy when he decided he wanted to pursue a career working more directly with people. In physical therapy school, he developed a love of anatomy under the guidance of former department chair and anatomy teacher Dr. Carolee Moncur. He then proceeded to earn his PhD under the guidance of Dr. Kurt Albertine in the Department of Neurobiology and Anatomy within the School of Medicine. His education in engineering, physical therapy, and anatomy, combined with assistance from Dr. Lee Dibble, Dr. Paul LaStayo and Dr. Andy Anderson helped him found the Motion Analysis Core Facility. Since opening the lab, he has developed collaborations across campus and the country, performing biomechanics research and ultimately joining the osseointegration research team directed by Dr. Sarina Sinclair and Dr. Kent Bachus.

More than anything else, collaboration is what drives Dr. Foreman. He says he is lucky to work with such a smart group of people and is constantly learning from those around him. One of those people is Dr. Bart Gillespie.

Dr. Gillespie began in outpatient orthopedic physical therapy after graduating from physical therapy school before working in the area of inpatient physical therapy and wound care at the Veterans Administration Medical Center (VA). He soon joined the osseointegration team at the VA because, from the ground up, the implant was being designed with a rehab model in mind. He was involved in the earliest stages to help formulate what the therapy would look like and how to make it effective.

The two of them, alongside researchers from the Bone and Joint Research Lab at the VA, bioengineering, orthopaedics, infectious disease, plastic surgery and others, are currently researching osseointegration to increase functional mobility and the quality of life in people who have received lower extremity and upper extremity limb amputation.

The process of osseointegration includes two separate surgeries. The first places an implant into the distal end of the amputated femur or humerus. After a 6-week healing period, a second surgery places a post through the skin and into the implant, for which a prosthetic device can be attached. With a direct skeletal attachment of the prosthetic, the hope is to increase activity level, allow wearers to have better awareness of where their limb is in space, and reduce the time required to don and doff their prosthetic. The new process takes only seconds compared to traditional socket attachment that takes minutes.

Currently, transfemoral implants have been placed in ten participants as part of an early feasibility study and a multicenter study is scheduled to start enrolling in 2022. Furthermore, recruitment, selection process, and initial testing for transhumeral implants has already begun.

According to Dr. Foreman, initial results have been very promising. One participant can now ride a bike where he was unable to before and another who was primarily wheelchair-bound because his residual limb was not long enough to retain a socket prosthetic can now stand and walk independently. As of now, Dr. Gillespie says, a participant can start weight-bearing through the implant the day after the second surgery and maybe ambulating within a week with only a cane.

With such potential and benefit to the amputee population, the goal is to get full FDA approval for osseointegration, but that is a long and complicated process. Working with a research facility, a government facility, the University of Utah, the VA, private manufacturing companies and getting FDA approval, it may take 20 years to get osseointegration implants to market. “All of it has to be done to become the standard of care,” Dr. Gillespie states, “In the end, it will make the device more accessible for the patients and help benefit the everyday amputee.”

But even a daunting timeline won’t lessen the day-to-day benefits of their work. As Dr. Gillespie says, “Getting to help people walk, helping them with their prosthetics, helping them heal wounds –ultimately helping maximize quality of life. Seeing patients improve. That’s the most exciting part of my job.”