A patient dubbed the ‘real bionic woman’ has become the first human to be fitted with a controllable limb fused with both her nervous and skeletal systems.
The Swedish woman, named Karin, 50, was fitted with her intelligent artificial limb some years ago after losing her right hand in a farming accident more than two decades earlier.
An interdisciplinary global research team developed the intelligent limb using osseointegration – a process where bone tissue embraces titanium creating a strong mechanical bond – and enabling connection with the nervous system via electrodes implanted in the nerves and muscles.
Karin, an engineer, says her groundbreaking bionic arm reduces her phantom pain and has been ‘life-changing’ in returning her capabilities in everyday life and regaining her independence.
The authors of the breakthrough study, published in the journal Science Robotics, say the results offer a silver lining for amputees the world over.
The first person to receive the space-age bionic limb, named only as Karin in the study, suffered a tragic farming accident over 20 years ago which sadly claimed her right arm.
In the following years, she endured excruciating phantom limb pain and found that existing, conventional prosthetic limbs were of little help in daily life, as well as being uncomfortable.
On the pain she experienced, Karin explained: “It felt like I constantly had my hand in a meat grinder, which created a high level of stress and I had to take high doses of various painkillers.”
However, this all changed when a prosthetic limb encompassing groundbreaking bionic technology was developed for her.
The surgery was done in December 2018, and she started using the arm in mid 2019 so has had it functionally for four years.
Mechanical attachment and reliable control of prosthetic limbs are two of the biggest obstacles in artificial limb replacement, with many amputees opting to reject even the most sophisticated, commercially available artificial limbs due to fears of painful and uncomfortable attachment and limited, unreliable control.
However, a multidisciplinary group of engineers and surgeons from Sweden, Australia and Italy aimed to solve these problems by developing a remarkable interface that fuses human and machine to allow the limb to be comfortably attached whilst enabling electrical connection with the nervous system.
Lead researcher Dr. Max Ortiz Catalan, head of neural prosthetics research at the Bionics Institute in Australia and founder of the Center for Bionics and Pain Research (CBPR) in Sweden, explained that the fact Karin has been able to use her bionic limb for a number of years was very encouraging.
Dr. Ortiz Catalán said: “Karin was the first person with below-elbow amputation who received this new concept of a highly integrated bionic hand that can be used independently and reliably in daily life.
“The fact that she has been able to use her prosthesis comfortably and effectively in daily activities for years is a promising testament to the potential life-changing capabilities of this novel technology for individuals facing limb loss.”
The main challenges facing the researchers at this level of amputation were the two bones – the radius and ulna – that should be aligned and loaded equally, and the fact that not much space is available for implanted and prosthetic components.
However, the team managed to develop a suitable neuromusculoskeletal implant that allows connections between the user’s nervous system and the electronic control system of the bionic limb.
“Our integrated surgical and engineering approach also explains the reduction in pain,” Dr. Ortiz Catalán added.
“Karin is now using somewhat the same neural resources to control the prosthesis as she did for her missing biological hand.”
Another key feature of the new bionic limb is the skeletal attachment of the prosthetic via osseointegration; a process in which bone tissue embraces titanium to create a strong, mechanical connection.
This area of the study was headed by Professor Rickard Brånemark – a research affiliate at the Massachusetts Institute of Technology (MIT) and associate professor at Gothenburg University in Sweden.
Brånemark, who has worked with osseointegration for limb prosthesis since it was first introduced to humans, said: “The biological integration of titanium implants into bone tissue creates opportunities to further advance amputee care.
“By combining osseointegration with reconstructive surgery, implanted electrodes, and AI, we can restore human function in an unprecedented way.
“The below elbow amputation level has particular challenges, and the level of functionality achieved marks an important milestone for the field of advanced extremity reconstructions as a whole.”
The nerves and muscles in the residual limb were re-arranged to provide more sources of motor control information to the prosthesis.
This part of the complicated surgery was conducted by Dr. Paolo Sassu at the Sahlgrenska University Hospital in Sweden – where he previously led the first hand transplantation performed in Scandinavia.
“Depending on the clinical conditions, we can offer the best solution for our patients which sometimes is biological with a hand transplantation, and sometimes is bionic with neuromusculoskeletal prosthesis,” Dr. Sassu said.
“We are continuously improving in both.”
The study was one of the main outcomes of a project funded by the European Commission under Horizon 2020 called DeTOP.
Coordinator Professor Christian Cipriani, from Scuola Sant’Anna in Pisa, explained: “The DeTOP project offered a great opportunity of collaboration which made possible the consolidation of state-of-art prosthetic and robotic technologies available in our institutions, that may have a terrific impact on people’s lives.”
The robotic hand – called the Mia Hand – was developed by Prensilia; an Italian company developing robotic limbs.
It features unique motor and sensory components that allow the user to carry out 80 percent of their daily activities.
Dr. Francesco Clemente, the Managing Director of Prensilia, said: “The acceptance of the prosthesis is critical for its successful use.
“Besides technical performance, Prensilia struggled to develop a hand that could be fully customizable aesthetically.
“Mia Hand was born to be shown and not hidden. We wanted the users to be proud of what they are, rather than ashamed of what was lost.”
For Karin, the bionic limb has offered exactly that.
She says the robotic limb has improved her functionality, increased her independence and, due to the highly advanced integration between her residual limb and her bionic one, has also massively relieved her pain.
“I now have better control over my prosthesis, but above all, my pain has decreased,” Karin said.
“Today, I need much less medication. For me, this research has meant a lot, as it has given me a better life.”
Produced in association with SWNS Talker
