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Updated: May 7, 2026
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Characterization of the Sense of Agency over the Actions of Neural-machine Interface-operated Prostheses
Published on: January 7, 2019
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Human Implementation of Upper Extremity Amputation Incorporating Agonist-Antagonist Myoneural Interface Construction
Matthew J Carty1,2, Michael Fernandez2,3, 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.
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.
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