The Extremity Trauma and Amputation Center of Excellence joined the Defense Health Agency as the latest addition to the organization on Oct. 23. The EACE is now the fifth center of excellence within the DHA Research and Engineering Directorate. The transition to DHA aligns with the Department of Defense’s move to streamline military medical systems for health and improved health services for over 9.6 million beneficiaries.

In 2009, the National Defense Authorization Act directed the DOD and the Department of Veterans Affairs to jointly establish a center of excellence in the mitigation, treatment, and rehabilitation of traumatic extremity injuries and amputations.

Since its official launch in 2011, the EACE has supported cutting-edge medical care for all service members and other beneficiaries with extremity trauma, including amputations. The agency’s mission is to lead the advancement of extremity trauma-related research and clinical practice innovations to optimize outcomes of service members and veterans, while also meeting the needs of the combatant commands and the Military Health System.

“We provide comprehensive clinical policy, education programs, research translation, and functional outcomes analysis to support the clinical continuum of care to bring our patients to a maximum level of function post-injury,” said John Shero, the executive director of EACE. “Our transition to the DHA enhances our ability to synchronize programs, clinical professionals, and research across the service branches and with the VA.”

As part of the EACE Research and Surveillance Division, multidisciplinary teams of researchers are embedded within military hospitals and clinics, offering unique perspectives to support both patients and health care providers.

“Having our research teams embedded in military hospitals and clinics makes us ideally situated to conduct a wide variety of research activities across the scientific continuum, while at the same time improving the timeliness and effectiveness of translating knowledge and materiel products to frontline clinicians and the care they provide,” said Dr. Christopher Dearth, chief of research and surveillance at EACE. “This ‘bench-to-bedside’ approach allows us to support health care providers with delivering the highest quality care to service members and veterans with extremity trauma.”

Since 2017, the EACE has received over $30 million in research funding and currently executes over 60 research projects focused on five core areas of investigation:

• Optimizing post-musculoskeletal injury time to return-to-duty.

• Exoskeletons to enable service member lethality during prolonged care.

• Acute care therapeutics for enhancing outcomes of neuromusculoskeletal trauma.

• Enhancing musculoskeletal rehabilitation outcomes within the military health system.

• Epidemiology and surveillance of the extremity trauma and amputation population.

The transition to DHA gives EACE wider flexibility and resources to help develop DOD policy and evidence-based clinical practice guidelines for implementation across the department, two areas Shero prioritizes.

“In addition to expanding our research capabilities, publishing manuscripts in peer-reviewed scientific journals, and preparing scientific abstracts which are presented at leading national and international conferences, we are also focusing our attention on developing clinical training opportunities to further enhance and standardize clinical care,” he said. “Limb trauma clinical practice guidelines are being developed and refined in concert with the VA and other national organizations to optimize care and sustain a ready medical force, both for the U.S. military and our partner nations’ militaries as well.”

The EACE has collaborated with geographic combatant commands to improve partner nation capabilities to treat severely injured service members in more than a dozen countries. Shero recognized the importance of establishing and maintaining relationships with military medical personnel from partner nations.

“Supporting the theater campaign plans of our combatant commanders is a key focus area for us,” he said. “Helping to build trust and confidence in our medical collaborations, sharing information, and coordinating mutual activities in amputee and extremity trauma-related care contributes to stronger ties and a stronger military force.”