By Jay Agarwal, MD, Jeremy Gililland, MD, and Sarina Sinclair, PhD
This Veterans Day, we pause to honor those who have served our nation and recognize how their sacrifice continues to advance health and well-being for people everywhere.
For 100 years, research funded by the U.S. Department of Veterans Affairs (VA) has transformed medicine far beyond its walls. Breakthroughs that began as solutions for veterans-such as the cardiac pacemaker and the nicotine patch-have become innovations that improve lives for us all.
As we celebrate a century of VA research, we also celebrate a powerful local partnership: the collaboration between University of Utah Health and VA Salt Lake City Health Care. Together, we're advancing discoveries that honor veterans through exceptional clinical care and ongoing research.
A Century of Discovery and Impact
When the VA's hospital-based research program launched in 1925, investigators focused on tuberculosis, toxic gas exposure, post-battlefield "shell shock," and other pressing health challenges of that generation. Over the decades, VA researchers made discoveries that changed medicine itself.
They found an effective therapy for hypertension, linked cigarette smoking to cancer, developed the cardiac pacemaker, and proved colonoscopy as the best method for colon cancer screening. Two VA researchers even earned Nobel Prizes for groundbreaking discoveries in medical diagnostics and hormone biology.
Every decade of VA research has built on the last, creating a legacy of scientific progress that benefits all of us.
Utah's Legacy of Innovation and Partnership
In 1946, University of Utah Health partnered with VA Salt Lake City Health Care to pursue shared research goals. For nearly 80 years, we have collaborated on a growing body of research-from bacteriological studies to artificial limb technology-to address the ever-changing health concerns of veterans.
Today, 150 investigators hold dual appointments at both institutions, overseeing more than 700 active research projects. In 2024, VA Salt Lake City received more than $57 million in research funding-ranking third in the nation. This robust partnership supports leading-edge work in orthopedics, cancer research, vascular medicine, behavioral health, and more.
The impact reaches far beyond Utah's borders. Discoveries born here not only improve veterans' health-they also advance medical care for civilians across the country.
Utah Researchers Leading High-Impact Prosthetic Advances
Some veterans who had amputations after combat trauma, motor vehicle accidents, or crush injuries find it difficult to use prosthetic limbs with socket technology. These devices can cause discomfort or instability because they shift as patients move.
For more than two decades, researchers at U of U Health and VA SLC have been developing an orthopedic implant to improve comfort and mobility for people with above-knee amputation. Roy Bloebaum, PhD, professor emeritus in orthopedic research and VA career research scientist, spearheaded our ongoing translational research program that has transitioned into clinical research trials.
The Percutaneous Osseointegrated Prosthesis (POP) is a prosthetic device that passes through the skin and attaches directly to the femur, similar to technology that anchors a tooth implant to the jawbone. It eliminates many complications associated with prosthetic socket technology.
The POP device is a data-driven design that went through extensive preclinical testing, both in laboratories and within a unique large animal model developed by our Utah team. They collected data on the biological and biomechanical response to the implanted device. This paved the way for a first-in-human early feasibility study that ran from 2015 to 2019. Ours was the first FDA-approved pilot trial in the U.S. for this type of prosthetic.
Utah is the Hub for a Multi-Center Clinical Trial
VA SLC is the lead site for a large, multi-center clinical trial currently underway for the POP. The study is sponsored by the Cooperative Studies Program within the VA Office of Research and Development. Results from this large trial will be submitted to the U.S. Food and Drug Administration with the goal of gaining premarket approval for the POP, making it widely available to amputees across the U.S.
The POP's biomechanical design is intended to allow users to move more naturally, closer to their pre-amputation gait. Our early feasibility study showed that patients who used the POP spent more time using their prosthetic and their overall activity level increased. For some wheelchair-bound patients who could not use socket technology, the POP made it possible for them to walk again pain free.
The VA health care system provides an ideal environment for conducting longitudinal research like this. It offers a vast network, robust funding, resources, equipment and facilities, and mentorship programs for younger and established researchers that encourage them to stay with the institution.
Developing Young and Established Researchers
The VA's success depends on its commitment to developing both emerging and established investigators. Through Career Development Awards, promising young researchers receive mentorship and training from experienced VA scientists. Meanwhile, Merit Awards-four-year grants similar to NIH's R01 program-fund seasoned investigators whose work addresses key health concerns among veterans.
This continuum of support ensures that VA research remains a vibrant ecosystem, where collaboration and mentorship drive lasting innovation.
The Lasting Value of VA Research-for Everyone
VA research not only delivers groundbreaking treatments for veterans but also accelerates the pace of discovery for everyone. Veterans gain access to cutting-edge therapies through clinical trials like the POP study, while civilians benefit from the ripple effects of these advances in broader medical care.
Despite challenges in funding, the mission remains clear: to improve health and quality of life through science. For a century, VA research has embodied that mission, transforming the unique experiences of veterans into insights that make all of us healthier.
As we honor our veterans this November, we also celebrate the spirit of service that drives VA research forward. It's a reminder that when we invest in the health of those who served, we invest in the well-being of us all.
Jayant (Jay) Agarwal, MD
Jay Agarwal is a member of the Percutaneous Osseointegrated Prosthesis (POP) collaborative research team at University of Utah Health and VA Salt Lake City Health Care. Agarwal is a professor in the Department of Surgery and Chief of the Division of Plastic Surgery at the Spencer Fox Eccles School of Medicine at the University of Utah. His clinical interests include hand surgery and reconstructive microsurgery with a focus on reconstruction of traumatic injuries and defects caused by cancer. Agarwal received an MD from Case Western Reserve University and completed residencies in surgery and plastic surgery at the University of Chicago and a fellowship in hand and micro surgery at the Buncke Clinic.
Jeremy Gililland, MD
Jeremy Gililland is a member of the Percutaneous Osseointegrated Prosthesis (POP) collaborative research team at University of Utah Health and VA Salt Lake City Health Care. Gililland is a professor in the Department of Orthopaedics at the Spencer Fox Eccles School of Medicine at the University of Utah. He specializes in adult reconstructive orthopedic surgery of the hip and knee. His research interests focus on biomechanics of hip and knee replacements, revision joint replacement techniques, the use of intraoperative fluoroscopy to improve implant positioning, and periprosthetic joint infection. Gililland received an MD at the University of California Irvine School of Medicine and completed residency in orthopedic surgery at the University of Utah, a fellowship in adult reconstruction at the OrthoCarolina Hip and Knee Center, and the Knee Society John N. Insall Traveling Fellowship.
Sarina Sinclair, ME, PhD
Sarina Sinclair is the primary investigator for the Percutaneous Osseointegrated Prosthesis (POP) collaborative research team at University of Utah Health and VA Salt Lake City Health Care. Sinclair is an associate professor in the Department of Orthopaedics at the Spencer Fox Eccles School of Medicine at the University of Utah. She leads the Utah Osseointegration Clinical Research Lab. Her research interests focus on advancing new prosthetic and therapeutic strategies to improve the health and clinical monitoring of patients with limb loss. Sinclair received an ME at Tulane University, a PhD at Clemson University, and completed a postdoctoral fellowship in orthopedics at the University of Utah.
