Osseointegrated amputation prostheses and implanted electrodes

Book chapter, 2021

The load transfer from the external prosthesis to the residual limb via the socket can cause significant stress on the soft tissues, leading to irritation and skin ulcers. Osseointegrated bone-anchored prostheses systems create a direct structural and functional connection between the prosthesis and residual skeleton. Up to date, standardized implant systems, surgical techniques, and postoperative rehabilitation protocols have been developed for osseointegrated prostheses for the rehabilitation of amputees (OPRA), which has resulted in better functionality, fewer complications, and a better quality of life for implant recipients. The OPRA implant systems can now incorporate neuromuscular electrodes to facilitate myoelectric control and sensory feedback, which is especially important for upper extremity amputees. The latest development, called the osseointegrated human-machine gateway, allows for permanent implantation of neuromuscular electrodes, which provide long-term stable signals for myoelectric control, independent of limb position or environmental conditions, as well as artificial sensory feedback. In addition, the modular design of this system allows any part to be upgraded or replaced with minimal disturbance to the other components. The osseointegrated implants and the human-machine gateway represent frontiers in amputee rehabilitation.