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Updated: May 7, 2026

Characterization of the Sense of Agency over the Actions of Neural-machine Interface-operated Prostheses

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Human Implementation of Upper Extremity Amputation Incorporating Agonist-Antagonist Myoneural Interface Construction.

Matthew J Carty^1,2, Michael Fernandez^2,3, Corey L Sullivan¹

¹From the Division of Plastic and Reconstructive Surgery.

Plastic and Reconstructive Surgery

|December 15, 2025

Summary

The agonist-antagonist myoneural interface (AMI) offers benefits for upper-extremity amputations, mirroring positive outcomes seen in lower-extremity procedures. This novel surgical approach enhances residual limb preservation and function.

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Published on: October 29, 2021

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Last Updated: May 7, 2026

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Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Published on: October 29, 2021

Area of Science:

Reconstructive surgery
Biomedical engineering
Neuroprosthetics

Background:

The agonist-antagonist myoneural interface (AMI) is a surgical construct linking opposing muscles to restore neural feedback.
Previous studies show AMI benefits in lower-extremity amputations.
This study explores modified AMI for upper-extremity amputations (transradial and transhumeral).

Purpose of the Study:

To evaluate the efficacy of modified AMI in upper-extremity amputations.
To assess clinical, functional, and sensorial outcomes post-AMI surgery.
To compare results with lower-extremity AMI interventions.

Main Methods:

Modified upper-extremity amputation procedures incorporating AMI were performed.
Patient outcomes were prospectively collected at Brigham & Women's Hospital and WRNMMC.
Data included clinical, functional, and sensorial measures for analysis.

Main Results:

Seven patients underwent modified amputations (5 transradial, 2 transhumeral).
12-month follow-up showed 97% residual limb volume preservation and 6mm construct excursion.
83% of patients reported resolution of limb pain and phantom limb perception.

Conclusions:

Modified AMI construction in upper-extremity amputations shows promising results.
Potential benefits include improved limb volume preservation and functional outcomes.
AMI may offer advantages comparable to those in lower-extremity amputations.