Published 3/1/2012
Madeleine Lovette

Measuring the Success of EWI in Dollars and Sense

Last year was an extremely successful year in advocating for extremity war injury (EWI) research. Recently, Andrew N. Pollak, MD, who has been involved with these efforts for nearly a decade, sat down with AAOS Now to talk about the importance of investments in EWI research and the success achieved in this area through the efforts of the American Association of Orthopaedic Surgeons (AAOS).

AAOS Now: Dr. Pollak, the AAOS has had great successes with its EWI advocacy efforts over the past 6 years. Can you tell our members a little about those achievements?

Dr. Pollak: The AAOS has been engaged actively in advocacy programs to increase Congressional awareness about the need for increased funding for research on the best practices and treatments for orthopaedic trauma in general, and extremity war injuries in particular, since about 2007. That effort has been one of the most successful advocacy initiatives the AAOS has ever undertaken.

Prior to 2006, the U.S. government was investing zero dollars in research directed at improving care for extremity war injuries. In 2007, we were successful in achieving a $7.5 million dollar appropriation to the Department of Defense (DoD) to allow them to issue peer-reviewed, competitively awarded grants for investigators to study better ways to take care of severe war injuries.

Since then, funding has continued to increase. In 2009, $117 million was appropriated, resulting in the creation of the Major Extremity Trauma Research Consortium to address important questions regarding extremity trauma care.

Each year since 2007, funding from Congress for orthopaedic research on extremity war injuries has continued through the DoD. This success is 100 percent related to the efforts by the AAOS to educate Congress on the importance of addressing this topic.

AAOS Now: This year, the AAOS was particularly successful in increasing DoD investments for extremity trauma research. What was achieved and why is it important?

Dr. Pollak: Through Congress, the DoD received $30 million in 2011 for the DoD Peer Reviewed Orthopaedic Research Program (PRORP), the principal research vehicle for developing better treatments and outcomes for those who have extremity war injuries. That’s a 25 percent increase over the $24 million the program received last year.

This is an increase in an environment where almost everything else is being cut. That increase occurred because we were successful in convincing Congress about the importance of PRORP and the need for ongoing funding.

AAOS Now: With the conflicts winding down and troops coming home, why is investing in high-energy extremity trauma research still important?

Dr. Pollak: That is a great question, and let me focus on just three of the many reasons. First, the United States still has a population of wounded warriors with ongoing problems that will need to be addressed over the next decade and beyond. We as orthopaedic surgeons need to know about the best ways to take care of those injuries and the long-term consequences of those injuries.

Second, wars have been part of human history since the beginning of time. Just because the United States is beginning to pull out of the current wars in Iraq and Afghanistan, it doesn’t mean that we, as a country, won’t face additional wars and additional injuries that orthopaedic surgeons are going to have to treat.

Third, and probably the most relevant to AAOS members and their patients, is that the types of injuries that our wounded warriors are sustaining—although they are unique because they occur in a battlefield environment—are very similar to the types of injuries occurring on the roadways in the United States every day. What orthopaedic surgeons learn about the care of military trauma injuries can be translated to the civilian environment, thereby improving the quality of trauma care that civilian surgeons can offer to their patients.

AAOS Now: Given that extremity trauma research is important to both military and civilian populations, what are the AAOS’s future research and advocacy goals?

Dr. Pollak: One of our future advocacy goals is to ensure that this type of funding continues in perpetuity. It is our hope that funding to continually investigate better ways to take care of high-energy injuries will be a line item in the federal budget every year. We believe that the federal government needs to create programs within the National Institutes of Health, the DoD, and other agencies that will enable investigators to continue to look for better, more cost-effective ways to take care of severe injuries.

Madeleine Lovette is the communications specialist in the AAOS office of government relations; she can be reached at lovette@aaos.org

Additional Resources
EWI and AAOS efforts to increase funding for orthopaedic extremity research