Advanced Prosthetic Technology Driven by Breakthrough Scientific Research

Leach GA, Dean RA, Kumar NG, Tsai C, Chiarappa FE, Cederna PS, Kung TA, Reid CM.Plast Reconstr Surg Glob Open. 2023 Jul 17;11(7):e5127. doi: 10.1097/GOX.0000000000005127. eCollection 2023 Jul.  PMID: 37465283

Summary: In this collaboration with researchers at the University of California San Diego, we present the rationale for regenerative peripheral nerve interface surgery during limb amputation.  In addition, we perform an anatomic review and discussion on applying specific surgical techniques at each level of limb amputation. 

Vu PP, Vaskov AK, Lee C, Jillala RR, Wallace DM, Davis AJ, Kung TA, Kemp SWP, Gates DH, Chestek CA, Cederna PS. J Neural Eng. 2023 Apr 25;20(2):026039. doi: 10.1088/1741-2552/accbc0c. PMID: 37023743

Summary: Here we quantify the long term stability of RPNIs and surgically implanted electrodes in our clinical trial. We show the stable signals eliminate the inconvenience of frequent controller recalibration that is required by today’s state of the art systems.

Lee C, Vaskov AK, Gonzalez MA, Vu PP, Davis AJ, Cederna PS , Chestek CA, Gates DH. J Neural Eng. 2022 Nov 14;19(6). doi: 10.1088/1741-2552/ac9e1c. PMID: 36317254

Summary: This clinical case study compares the performance of our implanted electrodes to commercial state of the art technologies. The results indicate that patients can intuitively control multiple prosthetic hand functions with far greater accuracy and reliability using our technology.

Vaskov AK, Vu PP, North N, Davis AJ,  Kung TA, Gates DH, Cederna PS , Chestek CA. IEEE Trans Robot. 2022;38(5)2841-2857. doi: 10.1109/tro.2022.3170720. PMID: 37193351

Summary: In a clinical setting, we show that our implantable technology enables highly accurate, low latency control of individual finger movements and multiple grasps. This is due to algorithm selection and a fundamental improvement in signal quality over existing technologies.

Vu PP, Lu CW, Vaskov AK, Gates DH, Gillespie RB, Kemp SWP, Patil PG, Chestek CA, Cederna PS, Kung TA.  Plast Reconstr Surg. 2022 Jun 1;149(6):1149e-1154e. doi: 10.1097/PRS.0000000000009153. Epub 2022 Apr 11.PMID: 35404335 

Summary: This report describes early results of the use implanted electrodes to provide sensory precepts to two patients with upper limb amputation.  These results demonstrate that implanted electrode technology can restore proprioceptive and cutaneous sensory feedback that could significantly improve prosthesis use and embodiment.

Hooper RC, Cederna PS, Brown DL, Haase SC, Waljee JF, Egeland BM, Kelley BP, Kung TA.Plast Reconstr Surg Glob Open. 2020 Jun 4;8(6):e2792. doi: 10.1097/GOX.0000000000002792. eCollection 2020 Jun.PMID: 32766027 

Summary: This report discusses the use of regenerative peripheral nerve interface surgery to treat painful neuromas after digital and partial hand amputation injuries.  After RPNI surgery to treat neuromas, 85% of patients were either pain-free or considerably improved.

Vu PP, Vaskov AK, Irwin ZT, Henning PT, Lueders DR, Laidlaw AT, Davis AJ, Nu CS, Gates DH, Gillespie BR, Kemp SWP, Kung TA, Chestek CA, Cederna PS. Sci Transl Med. 2020;12(533)eaay2857. doi: 10.1126/scitranslmed.aay2857. PMID: 32132217

Summary: This first-in-human study shows that RPNIs capture otherwise lost motor function at varying levels of amputation. Two patients also had electrodes surgically implanted into RPNIs and remaining muscles for highly accurate individual finger control of a prosthetic hand.

Kubiak CA, Kemp SWP, Cederna PS, Kung TA.Plast Reconstr Surg. 2019 Sep;144(3):421e-430e. doi: 10.1097/PRS.0000000000005922.PMID: 31461024

Summary: The authors performed regenerative peripheral nerve interface surgery at the time of limb amputation and compared results to patients who underwent standard limb amputation.  The results demonstrate a significantly reduced experience of both postamputation neuroma pain and phantom limb pain. 

Vu PP, Irwin ZT, Bullard AJ, Shoshana AW, Sando IC, Urbanchek MG, Cederna PS, Chestek CA. IEEE Trans Neural Syst Rehabil Eng. 2018;26(2)515-526. doi: 10.1109/TNSRE.2017.2772961. PMID: 29432117

Summary: In this large animal study our researchers are able to accurately predict fine finger movements in real-time using RPNIs and implanted electrodes. Additionally, we quantify the stability of individual motor units recorded by the implanted electrodes.

Frost CM, Ursu DC, Flattery SM, Nedic A, Hassett CA, Moon JD, Buchanan PJ, Brent Gillespie R, Kung TA, Kemp SWP, Cederna PS, Urbanchek MG.J Neuroeng Rehabil. 2018 Nov 20;15(1):108. doi: 10.1186/s12984-018-0452-1.PMID: 30458876 

Summary: In this study, our researchers demonstrated that RPNIs can reliably acquire motor signals in a rat model and that those signals can be used to control a prosthetic device.  This research validates the idea that RPNIs are capable of facilitating real-time prosthetic control with signal contamination. 

Irwin ZT, Schroeder KE, Vu PP, Tat DM, Bullard AJ, Woo SL, Sando IC, Urbanchek MG, Cederna PS, Chestek CA. J Neural Eng. 2016;13(4)046007. doi: 10.1088/1741-2560/13/4/046007. PMID: 27247270

Summary: This study demonstrates long term stability and viability of RPNIs and surgically implanted electrodes in a large animal model. Additionally, the results indicate that finger movements can be accurately distinguished from RPNI signals.

Kung TA, Langhals NB, Martin DC, Johnson PJ, Cederna PS, Urbanchek MG.  Plast Reconstr Surg. 2014 Jun;133(6):1380-1394. doi: 10.1097/PRS.0000000000000168.PMID: 24867721

Summary: In an animal model, we demonstrate the long-term potential to use implanted electrodes to acquire discrete motor signals from regenerative peripheral nerve interfaces.  Results indicate that implanted electrodes did not negatively affect tissue viability and signal fidelity remained stable for the duration of the study period.

Morag Y, Ganesh Kumar N, Hamill JB, Cederna PS, Masotti M, Kemp SWP, Kung TA.Skeletal Radiol. 2023 Jun;52(6):1137-1157. doi: 10.1007/s00256-022-04256-6. Epub 2022 Dec 22.PMID: 36547677

Summary: This article discusses the ultrasound appearance of regenerative peripheral nerve interfaces in humans and provide correlations to clinical scenarios as well as comparisons to known histologic findings of RPNIs from previous animal models.