Journal
NEW ENGLAND JOURNAL OF MEDICINE
Volume 382, Issue 18, Pages 1732-1738Publisher
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMoa1917537
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Funding
- Integrum, the Promobilia Foundation
- IngaBritt och Arne Lundbergs Foundation
- Vinnova, an agency in the Swedish Ministry of Enterprise and Innovation
- Swedish Research Council
- ALF (Avtal om Lakarutbildning och Forskning) through a grant from the Vastra Gotaland region
- European Research Council under the European Union's Horizon 2020 research and innovation program [687905, 810346]
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After transhumeral amputation, four patients had implantation of a self-contained, osseointegrated prosthesis with a neuromusculoskeletal interface that allowed intuitive control of the prosthetic hand and arm over 3 to 7 years. A video shows use of the prostheses in daily life. We report the use of a bone-anchored, self-contained robotic arm with both sensory and motor components over 3 to 7 years in four patients after transhumeral amputation. The implant allowed for bidirectional communication between a prosthetic hand and electrodes implanted in the nerves and muscles of the upper arm and was anchored to the humerus through osseointegration, the process in which bone cells attach to an artificial surface without formation of fibrous tissue. Use of the device did not require formal training and depended on the intuitive intent of the user to activate movement and sensory feedback from the prosthesis. Daily use resulted in increasing sensory acuity and effectiveness in work and other activities of daily life. (Funded by the Promobilia Foundation and others.)
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