Prof. J.J. Trey Crisco’s research interests and translational efforts are in three fields: musculoskeletal biomechanics, sports, and pediatric rehabilitation.  His focus in upper extremity biomechanics is the hand and wrist for which he received the 2017 Kappa Delta Award from the American Academy of Orthopaedic Surgeons (AAOS) and Orthopaedic Research Society (ORS) with Dr. Scott Wolfe for their work on the wrist.  He also received the inaugural Goel Award from the American Society of Biomechanics (ASB) in 2017 for his translational research and social entrepreneurship.  His work has been primarily funded by the National Institute of Health (NIH) and has resulted in over 245 peer-reviewed publications. He has served on NIH study sections, editorial boards, and the scientific advisory committees of International Federation of Women's Lacrosse, US Lacrosse and USA Baseball. Prof. Crisco is the former Editor-in-Chief of the Journal of Applied Biomechanics and President of the American Society of Biomechanics. He has taught undergraduate Biomechanics and Product Design and Development, a joint effort between the Industrial Design Department at Rhode Island School of Design and the school of Engineering at Brown University.  He  actively mentors undergraduate, graduate, and medical students and orthopaedics residents.

Thumb carpometacarpal (CMC) osteoarthritis (OA) is a widespread, disabling disease of undetermined etiology that is far more prevalent in woman than in men. The disease affects 15% of adults over age 30, and two-thirds of women over the age of 55. Loss of thumb function alone imparts a 40%-50% impairment to the upper extremity due to its central role in nearly all grasp and handling tasks. Although recent studies suggest genetics, increased BMI and environmental factors (such as hand use) are likely associated with the development of thumb CMC OA, there is strong empirical and experimental data indicating that altered biomechanics plays a central role in the disease, and, importantly in its treatment. CMC OA is far more prevalent in women than men, and women have flatter joint surfaces, smaller areas of cartilage contact, and higher contact pressures. The interpretation of this is that the CMC joints in women are less biomechanically stable than those in men, and consequently at increased risk for altered joint loading and the onset and/or progression of OA. At this point, however, there are no published studies of CMC joint biomechanics in normal or OA-affected individuals, nor are there any longitudinal studies of joint biomechanics as the disease progresses. We hypothesize CMC joint laxity differs with age and gender, and that joint laxity will predict OA progression in symptomatic, early-stage patients, where CMC joint laxity is defined as articular kinematics that are abnormal in direction and/or magnitude.
This study is designed to generate foundational data on thumb CMC biomechanics in vivo by quantifying and comparing the differences in CMC biomechanics in older women (n = 11, age 45-75 yrs.) and younger women (n = 11, age 18-25 yrs.), and between women and men (n = 11, age 18 – 25 yrs; and n = 11, age 45-75 yrs.) using a cross-sectional experimental design (Aim 1), and, using a longitudinal experimental design, to determine if CMC joint laxity is positively associated with CMC OA progression 1.5 and 3 years after initial diagnosis in patients (N = 80; 45-75 yrs.) who initially present with CMC pain and minimal radiographic evidence of OA (Eaton I/II) (Aim 2). Aim 1 will provide the first in vivo data to date on 3-D biomechanics of the CMC joint during functional tasks, which should provide insight into the role of biomechanics in the disease, and reasons for the high prevalence of OA in women as compared to men. Aim 2 will provide the first quantitative assessment of the biomechanical changes that occur in the CMC joint during early OA progression in this population and will provide the foundation for future studies designed to evaluate the mechanistic relationship between altered joint biomechanics and cartilage degradation. Together, these studies will provide data for the rational design of surgical procedures designed to restore, reproduce, or replace the structural anatomy of the complex CMC joint, as well as baseline data for future randomized control trials and risk factor studies.

Preclinical development and evaluation of an instrumented replacement trapezium (iTrapz) capable of measuring joint contact loads at the base of the thumb, establishing the rigor for a future clinical trial in trapezial arthroplasty. The numerous surgical treatments for late-stage osteoarthritis (OA) of the thumb carpometacarpal (CMC) – or trapeziometacarpal (TMC) – joint, are highly varied and suboptimal. TMC OA is a degenerative disease that results in significant impairment due to pain and loss of function. The prevalence of TMC OA is at least 20-25% in those over 50, and it increases into the eighth decade when as many as 80% have evidence of disease. High forces in the trapeziometacarpal joint are believed to influence OA development and treatment success. However, our understanding of joint loads developed in the hand is limited to predictions from mathematical models that have yet to be validated by in vivo measurements. Custom implants instrumented to measure joint contact loads have been developed for the hip, knee, and spine. Data from these implants has provided critical insight into joint function, with the tangible direct benefits of validating and improving musculoskeletal models and providing important information for implant designers and manufacturers. Instrumented implants also have the potential to provide highly novel biofeedback to patients to guide rehabilitation. Building on our extensive and rigorous in vivo studies of TMC morphology and kinematics, and the records of success in other instrumented joints, we propose to develop and validate a preclinical instrumented trapezium implant, which we refer to as the iTrapz. In our first aim we will design, fabricate and validate a proof-of-concept wired iTrapz. In Aim 2 we will validate the wired iTrapz in a cadaver model using a robotic musculoskeletal simulator. Once we complete these aims we will have a highly innovative load sensor suitable for cadaver studies. Given the need for more rigorous studies of thumb arthroplasties, this accomplishment alone will have a significant impact. In Aim 3 we will develop a first-prototype inductively powered and telemeterized iTrapz implant. In Aim 3 we will also begin planning for in vivo implementation in a clinical study. Upon completion of Aim 3 we will have demonstrated that measuring in vivo thumb loads during the activities of daily living is feasible, and we will have developed the necessary knowledge, skills and technologies to support the fabrication of a hermetically sealed implant suitable for clinical implementation. This project is significant in that it will benefit several constituencies: clinicians will benefit from the knowledge of the loads associated with disease, injury, surgery and repair; the modeling and research communities will benefit directly from measurements of joint loads during activities of daily living, which are unknown in the hand; and engineers and manufacturers will benefit from critically-needed performance data.

Motion-Specific Toy Controllers for Upper Extremity Rehabilitation in Children
Cerebral palsy (CP) is a neuromotor impairment comprised of a group of non-progressive clinical syndromes of children that are characterized by motor dysfunction and affects approximately one out of every 500 children. Physical therapy, occupational therapy, braces, orthotics, electrical stimulation, medications and surgery are the current major forms of treatment used to improve strength and joint range of motion, prevent contractures and increase function for hemiplegic cerebral palsy. Recent studies using constraint induced movement therapy and robotic therapy suggest that increased skilled use of disabled muscles may promote functional restoration. A challenge with constraint induced movement therapy is that this intensive therapeutic intervention requires casting a child's "good" limb. Robotic therapy is restricted in its use to institutional settings. The research described in this proposal will develop and evaluate a play controller that encourages the use of affected muscles in order to facilitate functional recovery beyond what can be achieved by currently available therapies. Our approach capitalizes upon a primary learning avenue for children - play. The premise of this proposal is that toy and computer game play will encourage extended use of the impaired limb. Our first specific aim is to optimize and validate the design of a therapeutic play controller for remote controlled (RC) toys and for computer games by comparison with standard optical motion capture measures. Our design requirements include: remote control of commercially available toys and computer games, sensing of targeted relative joint motion, configurable range and gain setting for sensed joint motion, and data recording of joint motion during play. Our second specific aim is to demonstrate the efficacy and usability of the Play Controller using two platforms (RC toys and computer games). This aim will be accomplished in a controlled clinic setting and in a 1-week home pilot study. Joint motion and play measures will be collected during the sessions and analyzed to demonstrate efficacy and usability. Our third specific aim is to acquire validated clinical and quality of life measures of the Play Controller to power our clinical trials. In addition to our clinical outcome measures of hand function, strength, spasticity and tone, we will include quality of life (QOL) measures assessing physical impact and psychosocial functioning. Building upon established therapies while addressing the limitations of their cost, accessibility, and motivation, the significance of our approach is the need for extended neuromuscular therapy in children with impairments. The potential benefits of the technologies developed within this project are translatable to patients of any age and a wide range of extremity neuromotor impairments. This R21 proposal is highly innovative in its approach to develop a play-motivated therapeutic device that incorporates targeted joint motion, massed-practice therapy, activity logging, existing toys and computer games, and cost-effectiveness.

ACTIVE

R21 AR077201-01    Crisco(PI)    04/01/2020 – 03/31/2022
NIH/NIAMS
Pre-Clinical Development of an Instrumented Trapezium Carpal Bone
The goal of this project is to develop a load-sensing bone implant capable of directly measuring the forces at the base of the thumb. There is no scientific overlap with the proposed project. There is a substantial benefit from the strengthening of our methodological approaches due to similar design challenges and technological solutions.
Role(PI)

R41 AR076303-01        Crisco(PI)  09/16/2019 – 08/31/2020 (NCE)
NIH/NIAMS
Additive Manufactured PEKK Implants for Small Bone Arthroplasty
The goal of this work is to determine the feasibility of fabricating replacement bones using 3D additive manufacturing of t polymer polyetherketoneketone (PEKK).
Role: PI

R01 AR059185-06 Crisco (PI)  07/01/2011– 08/31/2021
NIH/NIAMS
Thumb CMC Biomechanics and Early OA Progression
The goal is to generate foundational data on thumb carpometacarpal (CMC) biomechanics and on thumb CMC OA progression, with the aim of identifying potential biomechanical markers of OA progression.
Role: PI

P30GM122732 (previously P20GM104937)     Chen(PI)     10/01/2007 – 9/31/2022
NIH/NIGMS
COBRE for Skeletal Health and Repair
The goal for this center is to establish a multi-disciplinary translational research center focusing on cartilage and joint health, disease mechanisms, and repair strategies.
Role: Co-Director/Project Mentor

COMPLETED

RO1 NS094410-01A1 Duma (PI)  03/01/2015-02/28/2020
NIH/NINDS Virginia Tech; Subaward # 431861-19B56         
Biomechanical Basis of Pediatric mTBI Due to Sports Related Concussion
The proposed research will result in the development of novel protective equipment strategies, diagnostic tools for field use and other healthcare settings, novel strategies for return to play decisions, and educational tools for disseminating information about the evaluation and prevention of MTBI in the pediatric population.
Role: Subaward PI

1 R13 AR074278-01               Crisco (PI)                                                                      08/10/2018-07/31/2019
NIH/NIAMS
3rd International Thumb Osteoarthritis Workshop (ITOW).
The purpose of this R13 proposal wa to seek partial support for the 3^rd International Thumb Osteoarthritis Workshop (ITOW 2018), which was held on November 8-10, 2018, at the Stanford University School of Medicine. The workshop was focused on thumb carpometacarpal (CMC) osteoarthritis (OA), and brought together clinicians and basic researchers from multiple disciplines with the goal of advancing the treatment of thumb CMC OA. The workshop provided a unique, focused forum for the cross-discipline exchange of information regarding the etiology, pathogenesis, treatment and clinical outcome of the disease.
Role: PI

Crisco (PI) 06/01/2015-11/30/2019
Israel-U.S. Binational Industrial Research and Development (BIRD) Foundation
TIM Motor Control – a Therapeutic Games Platform for Pediatric Physical Therapy
The proposed research will develop and evaluate innovative motion-specific play controllers that are engaging rehabilitative devices for enhancing therapy and promoting neural plasticity and functional recovery in children with cerebral palsy.
Role: PI

Crisco (PI) 01/01/2015-06/01/2016 (NCE)
Timocco, Inc.
3D Accuracy and Repeatability of the Timocco Gaming System
Evaluate of accuracy and repeatability of the 2D Timocco tracking system by comparing the 2D results with the 3D results collected with laboratory based 3D motion detection system.
Role: PI

2P20-GM104937 (previously P20-RR024484) Chen (PI) 10/01/2007 – 9/31/2017                     
NIH/NIGMS
COBRE for Skeletal Health and Repair
Program grant focusing on cartilage health.
Role: Co-Director/Project Mentor

Crisco (PI) 02/01/2015-01/31/2016
Tornier, Inc.
Dynamic In Vivo Kinematics of Total Shoulder Arthroplasty
Our goal is to provide Fellow with participation in cutting–edge biomechanical research and measure shoulder kinematics in joint arthroplasty patients while they perform six functional tasks. Our lab is world-renown for work in the hand and wrist, and this study applies the same in vivo dynamic imaging technologies to the study of the shoulder.
Role: PI

R21HD071582-01A1 Crisco (PI) 07/01/2012-06/30/2015
NIH/NICHD
Motion-Specific Toy Controllers for Upper Extremity Rehabilitation in Children
This project proposes to provide physical therapy to children with impaired muscle function by designing, fabricating and evaluating novel play controllers that are actually hidden rehabilitative devices.
Role: PI

HD48638 Greenwald (PI) 04/07-01/12
NIH/NICHD
"Biomechanical Basis of Mild Traumatic Brain Injury (MBTI)"
The aims are to develop and validate a quantitative model of head impact acceleration that enables translational research to reduce the incidence and negative effects of MTBI.

P20RR024484 Chen (PI) 09/07-07/12
"COBRE for Skeletal Health and Repair"
The goal of this center is to establish a multi-disciplinary translational research center focusing on cartilage and joint health and disease mechanisms and developing repair strategies.

OREF/RJOS/DePuy - Career Development Award Ladd (PI) 7/10-6/11
"Thumb CMC Joint in Women: Anatomy and function in Symptomatic and Early Arthritis Subjects.".
Pilot study of kinematic imaging of the thumb in functional positions, to better understand causes and associations of this common arthritis. Role: Consultant

WM Keck Foundation Science and 02/07-09/11
Engineering Research Grant Brainerd (PI)
"Design and Construction of CTX imaging system for musculoskeletal biomechanics research." This project is a collaborative, multi-discinplinary project to design, construct and test a high-speed stereo-flouroscopic imaging system. Role on project: Subcontract PI

NIH/ NICHD R01 HD052127-01 Crisco (PI) 07/06-04/10
"3-D Multi-Articular Models of the Carpus." The project proposes to develop a 3-D multi-articular model of the wrist in order to gain insight into the normal function of the effects of surgical treatment on the ligamentous and cartilaginous structures of the wrist.

National Operating Committee on Standards
for Athletic Equipment (NOCSAE) Crisco (PI) 02/09-10/10
"Performance of Wood and Non-Wood Baseball Bats"
The specific aim of this study is to determine the actual bat performance of current metal and composite bats in players at three different levels: Little League, High School, and Collegiate.

USA Baseball Crisco (PI) 09/09-10/10
"Performance of Wood and Non-Wood Baseball Bats for Little League"
This study will determine the performance of baseball bats when swung by little league players using novel 3D methods and algorithms.

IPIC of the Greater Providence Chamber 03/10-12/10
of Commerce Crisco (PI)
"Toy Technology for Upper Extremity Rehabilitation in Children"
The goal is to create, test and fabricate 25 next-generation upper extremity rehabilitation toys.

Biomedical Research Grant - Kerman Special Fund Crisco (PI) 1/07 – 04/10
"Toys and Technologies for Rehabilitation"
This multi-disciplinary, collaborative project will develop and test toys that are hoped enhance the physical therapy regimen of children with various arm impairments due to brain injury, cerebral palsy or other neurological impairments.

American Society for Surgery of 09/09- 8/10
the Hand/Ortho. Research & Ed. Fdtn. Got (PI)
"Utilization of Computed Tomography to Evaluate the Mechanics of the First CMC Joint During Dynamic Loading" The objective is to determine the 3-D in vivo kinematics of the thumb CMC joint in normal hands and to determine if kinematics differ between men and women.
Role: Mentor to new PI

NIH/NIA 2 R01 AG017021-06 A2 Chen (PI) 12/05-1/10
"Biophysical Regulation of Chondrocyte Differentiation"
The long term goal of this project is to analyze the molecular mechanisms underlying matrix deformation-related cartilage growth using both in vitro and in vivo models. Role on project: Co-investigator.

NIH/NIAMS R01 ARO53648-01 Crisco (PI) 04/06-01/10
"Carpal Kinematics During Functional Tasks." The significance of this work is that it will provide novel data on the in vivo kinematics of the hand and forearm during functional tasks.

2017 J. Leonard Goldner Pioneer Research Award, Excellence and Innovation in Hand Surgery Research. “Validation of an Approach to Measure Implant Kinematics in TWA Patients”. Crisco JJ, Wolfe SW, Weiss A-PC, Moore DM, Shah K.

2017 Goel Award For Translational Research in Biomechanics.  The American Society of Biomechanics.  “Translational Journeys – Head Impact Sensors, Wrist Implants, Toy Controllers and Assistive Mobility” Crisco JJ

2017 Kappa Delta Elizabeth Winston Lanier Award, The American Academy of Orthopaedic Surgeons (AAOS), Research Development Committee (RDC), and Council on Research and Quality (CORQ).  “Kinematics of the Normal and Injured Wrist: The Importance of the Midcarpal Joint.” Wolfe SW and Crisco JJ

2014 Nicolas Andry Award, The Association of Bone and Joint Surgeons.  "The Puzzle of the Thumb - Mobility, Stability, and Demands in Opposition."  Amy Ladd, Joseph J. Crisco, Elisabet Hagert, Jessica Rose, and Arnold-Peter Weiss

TIME Magazine's The Best Inventions of the Year. November 12, 2007, page 86. Head Impact Telemetry (HIT) system Football Helmet. Crisco JJ and Greenwald RM Inventors. Developed by Simbex, LLC, sold by Riddell, Inc

2003 Bruce M. Selya Award for Research Excellence, Lifespan 11th Annual Research Celebration, Providence, RI 
 

American Society of Mechanical Engineers 1984 -

American Society of Biomechanics 1987-

 -- Chairman, Membership Committee 1995 - 1998

 -- Program Chair-Elect, Program Chair 1998 - 2000

 -- President Elect, President, Past-President 2003 - 2006

 -- ASB Awards Committee 2004

Orthopaedic Research Society 1989 -

ASTM (F08) American Society for Testing & Materials 1993 -

International Society of Biomechanics 1993 -

Cervical Spine Research Society 1994 - 2015

American Academy of Orthopaedic Surgeons 1996 -

International Wrist Investigators Workshop 2005 -

American Society for Surgery of the Hand 2017 -

Hand and Wrist Biomechanics International (HWBI) 1992 - 

Professor Crisco mentors undergraduates, masters, doctoral, medical students,and orthopaedic residents.  

Ongoing lectures on biomechanics, imaging, design, and product development.

Previously taught Biomechanics (at Brown) and Product Design and Development at Rhode Island School of Design (at RISD).