Engineering and prosthetics-orthotics have played an important role in the Department of Orthopaedic Surgery for more than thirty years. In this section we describe three programs: (1) The Prosthetics Research Laboratory (PRL), a joint program with the Jesse Brown VA Medical Center, (2) The Rehabilitation Engineering Research Program, a National Institute on Disability and Rehabilitation Research (NIDRR) funded program, and (3) The Prosthetic-Orthotics Education Program. The first two programs are concerned with medical engineering in orthopaedics and rehabilitation, primarily in the field of limb prostheses and orthoses (braces). The third program is educational, with certificate and short-term courses about prosthetics and orthotics. These programs are located in the Rehabilitation Institute of Chicago (RIC) and their focus is research, development, and education. To understand their existence in the department it is necessary to know about how they originated and developed. The description of their creation follows:

The Prosthetics Research Laboratory (PRL)

This laboratory was formed by Dr. Clinton L. Compere in the basement of the old RIC at 401 E. Ohio during summer 1956. Dr. Compere structured the laboratory within the Department of Orthopaedic Surgery but located it at the RIC. Dr. Compere had been chief of an army amputee service during and after WW II and his amputee clinic at the RIC was one of the first services offered by the Institute. The Institute had been founded by Dr. Paul B. Magnuson, former chair of the Department of Orthopaedic Surgery. At that time Dr. Magnuson was affiliated with the VA Medical Department in Washington, D.C. The VA was expanding its research program in limb prosthetics and it was natural for the Prosthetics and Sensory Aids Service of the VA to contract with Dr. Compere for prosthetics research work at Northwestern. Northwestern, through Dr. Magnuson and Dr. Klopsteg of the Technological Institute, had already been involved in the launching of the federally funded prosthetics research program in the U.S.A. in 1945, and Dr. Klopsteg had had a VA subcontract for prosthetics studies from 1945 to 1947.

Dr. Compere brought in an engineering director (Colin McLaurin) and a prosthetist (Fred Hampton), both from Canada, to start the laboratory. During those early days, the RIC was financially strained and the laboratory's rental payments were advanced to assist the RIC. This is mentioned to bring out the symbiotic relationship that has existed with the RIC from the beginning.

Mr. Edward C. Grahn, presently with the lab, directed it from 1964 to 1972. Dudley S. Childress, one of the early graduates of the Biomedical Engineering Center in Evanston, arrived in 1966 and has directed the lab since 1972. Orthopaedic surgeons involved with the laboratory over the years, besides Dr. Compere, have been Drs. Robert Thompson, Paul Meyer, Jr., and Robert Keagy.

The PRL moved to the fourteenth floor of the RIC in 1974, when the new RIC building was completed. The PRL thrived as one of the VA's primary contractors for prosthetics research until 1981, when it began operating through the VA Lakeside with funding from the VA Rehabilitation Research and Development Service. After almost 32 years it remains one of the VA's major centers for prosthetics research.

The Rehabilitation Engineering Research Program

Dr. Compere's success with limb prosthetics programs and his early involvement with total joint replacement surgery, put him in a strong light nationally, and in 1972 Northwestern University was recipient of a national Rehabilitation Engineering Center grant from the National Institute on Handicapped Research (NIHR), now the National Institute on Disability and Rehabilitation Research (NIDRR), with Drs. Childress and Compere as co-directors. It was one of the first five or six nationally designated centers in rehabilitation engineering. Because it was in a department at the University it was locally designated as a program. Dr. Jack Lewis was hired half-time (shared with civil engineering) as project director for biomechanics. Initially the research thrust concentrated on orthopaedic implants, particularly hip and knee implants, and upon assistive technical aids for profoundly disabled persons. At that time, knee implants had a two-year failure rate of about 20% and there was very little assistive equipment for persons with severe disabilities. Northwestern was active as an experimental center for joint implants, and the Midwest Spinal Injury Care System had just been established at Northwestern. Consequently, the research effort dovetailed nicely with new and active clinical programs.

The program moved to the fourteenth floor of the RIC in 1974. Its original research thrust continued until 1982 when limb prosthetics research replaced the assistive equipment development work. In 1987 the orthopaedic implant research work was replaced by limb prosthetics and orthotics, and the program is now NIDRR's designated Rehabilitation Engineering Center in Prosthetics and Orthotics. It has functioned for 22 years as a designated center (15 years in orthopaedic implants), albeit with some changes in research emphases. Orthopaedic surgeons involved with the program over the years, along with Dr. Compere, were Drs. William Kane, Richard Wixson, David Stulberg, George Shybut, James Hill, James Milgram, Robert Keagy, and Paul R. Meyer, Jr. The Department of Biological Materials of the Dental School has played a significant role in research (Drs. Eugene Lautenschlager and Evan Greener).

The Prosthetics and Orthotics Education Program

The education program in prosthetics and orthotics began at Northwestern about 1958, again at the instigation of Dr. Compere. It too was housed in the old RIC, fouth floor, 401 E. Ohio. The school was one of three established by the Vocational Rehabilitation Administration (VRA). The others were at New York University (NYU) and University of California at Los Angeles (UCLA).

The school began by offering primarily short-term courses for physicians, surgeons, therapists, nurses, prosthetists, and orthotists. A high demand for the courses resulted in the school's income exceedng expenses. In the beginning, prosthetists and orthotists obtained their training through short-term courses. Later, a full-time, five-month certificate program was established for persons wanting to enter the prosthetics/orthotics field. This certificate program is monitored by the American Board for Certification (ABC), and the curriculum must contain certain material required by the ABC, which is the accrediting agency in prosthetics and orthotics. The certificate program is followed by an internship before a student is eligible to take the certification examination in prosthetics or orthotics. The NYU program leads to a baccalaureate degree before certification. Currently about 10 prosthetics and orthotics schools operate in the U.S.A.

In 1974 the Prosthetics and Orthotics Education Program moved to the seventeenth floor of the RIC, where it is now located. Since moving to the seventeenth floor, it has increasingly shared space with the Prosthetics and Orthotics Clinical Services Department of the RIC.