Advanced techniques in amputation surgery and prosthetic technology in the lower extremity

Area of Science:

• Orthopaedic surgery
• Biomedical engineering
• Rehabilitation medicine

Background:

• Bone-anchored implants offer improved function and quality of life for lower-limb amputees with stump problems.
• High infection rates are a concern, necessitating an international registry for transparent overview of pros and cons.
• Advanced surgical techniques like targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) show significant benefits.

Purpose of the Study:

• To review current advancements in prosthetic technology for lower-limb amputees.
• To highlight the potential of emerging technologies like bionics and myoneuronal interfaces.
• To emphasize the need for integrated medical and financial strategies for advanced prosthetics.

Main Methods:

• Review of high-quality articles on TMR and RPNI.
• Discussion of bionic lower extremity advancements, including agonist-antagonist myoneuronal interfaces.
• Analysis of microprocessor-controlled prosthetic components and their clinical impact.

Main Results:

• Bone-anchored implants are a viable solution despite infection risks.
• TMR and RPNI techniques show beneficial effects and should be integrated into clinical practice.
• Microprocessor-controlled knees/ankles (A-MPK/As) demonstrate benefits, particularly for uneven terrain, but show inter-individual variability.

Conclusions:

• Continued research and funding are essential to advance prosthetic technology and evidence-based practice.
• Development of financing strategies alongside medical strategies is crucial for affordable access to cutting-edge solutions.
• Personalized prosthetic component selection is key to achieving amputees' everyday goals.