A highly integrated bionic hand with neural control and feedback for use in daily life.

Journal: Science robotics
Published Date: Oct 11, 2023

Abstract

Restoration of sensorimotor function after amputation has remained challenging because of the lack of human-machine interfaces that provide reliable control, feedback, and attachment. Here, we present the clinical implementation of a transradial neuromusculoskeletal prosthesis-a bionic hand connected directly to the user's nervous and skeletal systems. In one person with unilateral below-elbow amputation, titanium implants were placed intramedullary in the radius and ulna bones, and electromuscular constructs were created surgically by transferring the severed nerves to free muscle grafts. The native muscles, free muscle grafts, and ulnar nerve were implanted with electrodes. Percutaneous extensions from the titanium implants provided direct skeletal attachment and bidirectional communication between the implanted electrodes and a prosthetic hand. Operation of the bionic hand in daily life resulted in improved prosthetic function, reduced postamputation, and increased quality of life. Sensations elicited via direct neural stimulation were consistently perceived on the phantom hand throughout the study. To date, the patient continues using the prosthesis in daily life. The functionality of conventional artificial limbs is hindered by discomfort and limited and unreliable control. Neuromusculoskeletal interfaces can overcome these hurdles and provide the means for the everyday use of a prosthesis with reliable neural control fixated into the skeleton.

Authors

  • Max Ortiz-Catalan
    Division for Biomedical Engineering, Department of Signals and Systems, Chalmers University of Technology, Campus Johanneberg, 41296, Gothenburg, Sweden.
  • Jan Zbinden
    Center for Bionics and Pain Research, Mölndal, Sweden.
  • Jason Millenaar
    Integrum AB, Mölndal, Sweden.
  • Daniele D'Accolti
    Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.
  • Marco Controzzi
  • Francesco Clemente
  • Leonardo Cappello
  • Eric J Earley
    Center for Bionics and Pain Research, Mölndal, Sweden.
  • Enzo Mastinu
    From the Biomechatronics and Neurorehabilitation Laboratory, Department of Electrical Engineering, Chalmers University of Technology (M.O.-C., E.M.), the Department of Hand Surgery, Sahlgrenska University Hospital (P.S.), and the Department of Orthopedics, Gothenburg University (R.B.) - all in Gothenburg, Sweden; the Clinical Laboratory for Bionic Extremity Reconstruction, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna (O.A.); and the Center for Extreme Bionics, Biomechatronics Group, MIT Media Lab, Massachusetts Institute of Technology, Cambridge (R.B.).
  • Justyna Kolankowska
    Integrum AB, Mölndal, Sweden.
  • Maria Munoz-Novoa
    Center for Bionics and Pain Research, Mölndal, Sweden.
  • Stewe Jönsson
    TeamOlmed, Department of Upper Limb Prosthetics, Kungsbacka, Sweden.
  • Christian Cipriani
  • Paolo Sassu
    From the Biomechatronics and Neurorehabilitation Laboratory, Department of Electrical Engineering, Chalmers University of Technology (M.O.-C., E.M.), the Department of Hand Surgery, Sahlgrenska University Hospital (P.S.), and the Department of Orthopedics, Gothenburg University (R.B.) - all in Gothenburg, Sweden; the Clinical Laboratory for Bionic Extremity Reconstruction, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna (O.A.); and the Center for Extreme Bionics, Biomechatronics Group, MIT Media Lab, Massachusetts Institute of Technology, Cambridge (R.B.).
  • Rickard Brånemark
    From the Biomechatronics and Neurorehabilitation Laboratory, Department of Electrical Engineering, Chalmers University of Technology (M.O.-C., E.M.), the Department of Hand Surgery, Sahlgrenska University Hospital (P.S.), and the Department of Orthopedics, Gothenburg University (R.B.) - all in Gothenburg, Sweden; the Clinical Laboratory for Bionic Extremity Reconstruction, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna (O.A.); and the Center for Extreme Bionics, Biomechatronics Group, MIT Media Lab, Massachusetts Institute of Technology, Cambridge (R.B.).

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