The Extremity Trauma and Amputation Center of Excellence:
Overview of the Research and Surveillance Division
Christopher A. Rábago, PT, PhD*†; Mary Clouser, PhD*‡; Christopher L. Dearth, PhD*§;
Shawn Farrokhi, PT, PhD*∥; Michael R. Galarneau, MS, EMT*‡; CPT M. Jason Highsmith, SP USAR*¶**††;
Jason M. Wilken, PT, PhD*†; Marilynn P. Wyatt, PT, MA∥; LTC Owen T. Hill, SP USA*†
ABSTRACT Congress authorized creation of the Extremity Trauma and Amputation Center of Excellence (EACE)
as part of the 2009 National Defense Authorization Act. The legislation mandated the Department of Defense (DoD)
and Department of Veterans Affairs (VA) to implement a comprehensive plan and strategy for the mitigation, treat-
ment, and rehabilitation of traumatic extremity injuries and amputation. The EACE also was tasked with conducting
clinically relevant research, fostering collaborations, and building partnerships across multidisciplinary international,
federal, and academic networks to optimize the quality of life of service members and veterans who have sustained
extremity trauma or amputations. To ful
ﬁll the mandate to conduct research, the EACE developed a Research and Surveillance
Division that complements and collaborates with outstanding DoD, VA, and academic research programs across
the globe. The EACE researchers have efforts in four key research focus areas relevant to extremity trauma and
amputation: (1) Novel Rehabilitation Interventions, (2) Advanced Prosthetic and Orthotic Technologies, (3) Epidemiology
and Surveillance, and (4) Medical and Surgical Innovations. This overview describes the EACE efforts to innovate,
discover, and translate knowledge gleaned from collaborative research partnerships into clinical practice and policy.
In 2009, Congress legislated the creation of the Extremity
Trauma and Amputation Center of Excellence (EACE) as a
joint enterprise between the Department of Defense (DoD)
and Department of Veterans Affairs (VA) to optimize the
quality of life (QoL) of service members and veterans who
sustain extremity trauma or amputation.
conduct clinically relevant research, foster collaborations, and
build partnerships across multidisciplinary international,
federal, and academic networks. In accordance with this
mandate, the EACE
’s mission is focused on the mitigation,
treatment, and rehabilitation of traumatic extremity injuries and
amputations. The purpose of this editorial is to provide an over-
view of the EACE efforts to innovate, discover, and translate
knowledge gleaned from collaborative research partnerships
across established DoD, VA, and academic research programs.
At the time of the
ﬁrst EACE staff hire in September 2011,
the U.S. military was engaged in nearly 10 years of continu-
ous combat. As of October 1, 2015, data compiled from the
Expeditionary Medical Encounter Database, Naval Health
Research Center, indicate that approximately 26,000 trau-
matic extremity injuries resulted from deployments during
Operations Enduring Freedom (OEF), Iraqi Freedom, (OIF)
and New Dawn (OND). These injuries ranged in severity and
complexity, with nearly 50% involving the lower limbs.
From 2001 to 2015, 1,687 individuals with major limb ampu-
EACE Amputee Registry. Of these individuals, 69% suffered
a single limb loss injury and 31% lost multiple limbs. The over-
all incidence of extremity injuries from these operations is
consistent with previous wars, comprising more than half of
all combat wounds.
With extremity injuries sharply rising early in the con
leadership within the DoD and VA health care systems
realized the need for specialized systems of care that could
deliver concentrated, interdisciplinary health care required by
*Extremity Trauma and Amputation Center of Excellence, 2748 Worth
Road, Suite 29, Joint Base San Antonio Fort Sam Houston, TX 78234.
†Center for the Intrepid, Department of Rehabilitation Medicine, Brooke
Army Medical Center, 3551 Roger Brooke Drive, Joint Base San Antonio
Fort Sam Houston, TX 78234.
‡Naval Health Research Center, 140 Sylvester Road, San Diego,
§Research and Development Section, Department of Rehabilitation,
Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda,
∥The Department of Physical and Occupational Therapy, Naval Medical
Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134.
¶James A. Haley Veterans Administration Hospital, Center of Innovation
in Disabilities and Rehabilitation Research, 8900 Grand Oak Circle (151R),
Tampa, FL 33637.
**University of South Florida, Morsani College of Medicine, School of
Physical Therapy & Rehabilitation Sciences. 3515 E. Fletcher Avenue,
Tampa, FL 33612.
††U.S. Department of Veterans Affairs, Rehabilitation and Prosthetics
Services, 810 Vermont Avenue, NW Washington, DC 20420.
The view(s) expressed herein are those of the author(s) and do not
ﬂect the ofﬁcial policy or position of Brooke Army Medical Center,
San Diego, James A. Haley Veterans Administration Hospital, Naval
Health Research Center, the Department of the Army, the Department of
the Navy, the Department of Defense, the Department of Veterans Affairs,
or the U.S. Government.
MILITARY MEDICINE, Vol. 181, November/December Supplement 2016