Will Nerve intervention help the future of prosthetics?

 

Over the years, prosthetics technology has grown whether it is for arms or legs. Prostheses are something that helps “ replace a missing part of the body or to make a part of the bodywork better” (Encyclopedia). Technology around prosthetics has grown because the need for prostheses has become high. When discussing prosthetics, the word of osseointegration and how this can help with mobility. To see if nerve intervention would help, one must look at how osseointegration works.   

Osseointegration is a type of prosthesis that is used to increase mobility. Osseointegration is when, “direct attachment for the prosthesis is created by surgically implanting a threaded titanium implant (fixture) into the bone, and an additional titanium implant (abutment) connected to the fixture and penetrating the skin” (Jönsson). This can help when there is amputation around a socket for example an elbow. Instead of having the prosthetic outside of the body, osseointegration is something that is directly on the bone. Jönsson et al looked at how past prostheses made the patients uncomfortable. They found that “ Most candidates for the osseointegration procedure had a history of problems with their previous socket prostheses. The majority suffered from skin/tissue problems, had problems with sweating, or had extremely short residual limbs, which in some cases caused low prosthetic use or nonuse” (Jönsson). Jönsson et al found that by having osseointegration, patients were more relieved as well as had more mobility. Nerve reinnervation is something that is directing a nerve that was attached to a muscle that is gone and redirects it into another muscle. Dumanian et al saw that having TMR that it “resulted in improved phantom limb pain and trended toward improved residual limb pain in major limb amputees compared with conventional surgical therapy” (Dumanian). Since amputation leads to a nerve neuroma, this shows that TMR lessens the pain. 

Since prosthetics is leading in a positive direction with osseointegration and how there is more movement out of it as well as less irritation on the skin but nerve reinnervation can help increase the knowledge more on the nerves themselves. The nerves that are not being treated lead to a high neuroma, therefore, leads to excruciating phantom pain. In the future of prosthetics, there can be new prosthetics that take these nerves and join them to the prosthetic for them to have less phantom pain as well as more movement. 

Dumanian, Gregory A. et al. "Targeted Muscle Reinnervation Treats Neuroma And Phantom Pain In Major Limb Amputees". Annals Of Surgery, vol 270, no. 2, 2019, pp. 238-246. Ovid Technologies (Wolters Kluwer Health), doi:10.1097/sla.0000000000003088. 

Encyclopedia, Medical. "Prosthesis: MedlinePlus Medical Encyclopedia". Medlineplus.Gov, 2021, https://medlineplus.gov/ency/article/002286.htm. 

"Osseointegration Amputation Prostheses On The Upper Limbs: Methods, Prosthetics And Rehabilitation - Stewe Jönsson, Kerstin Caine-Winterberger, Rickard Brånemark, 2011". SAGE Journals, 2021, https://journals.sagepub.com/doi/full/10.1177/0309364611409003.