Emily Pettersen Electrical engineering

Emily Pettersen is a PhD student in the research group Bionics at the unit Systems and control. 

Discussion leader is Dr Yan Li from Karolinska Institutet.

Examiner is Petter Falkman from Systems and controls.

Abstract
Individuals facing major limb amputation confront two primary challenges: restoring lost function and
managing amputation-related pain. Bone-anchored "osseointegrated" limb prostheses represent a
solution for the first challenge, involving the direct attachment of a prosthesis to the individual's
skeleton. This approach has significantly improved functional outcomes by overcoming some
drawbacks of conventional socket prostheses, such as skin irritation and nerve compression. A
successful bone-implant interface is crucial for this technique to function efficiently, and in some cases,
there is a need to enhance the osseointegration process. This work examined the application of
electrical stimulation to improve osseointegration through a literature review and in vitro experiments
testing different pulsed electrical stimulation parameters. The findings suggest that electrical
stimulation has the potential to enhance osseointegration, although optimal stimulation parameters
have yet to be determined. Results from the in vitro experiments indicate that pulsed electrical
stimulation, similar to peripheral nerve stimulation in artificial limbs, holds promise for improving cell
survival and may offer a viable approach to enhance peri-implant bone healing.
Surgical interventions for addressing postamputation pain have gained popularity in recent years.
This is due to the development of new surgical techniques specifically designed to promote a "healthy" and
natural regeneration of nerves following neuroma removal. The two most widespread techniques,
Targeted Muscle Reinnervation (TMR) and Regenerative Peripheral Nerve Interface (RPNI) have shown
beneficial outcomes for both treating and preventing the development of postamputation pain.
However, there is a lack of high-quality data providing evidence that these techniques are superior to
the standard of care. Here, we designed and are currently executing a multicenter, international,
randomized controlled trial (RCT) comparing TMR and RPNI to each other and to a standard procedure
in terms of effectiveness in treating postamputation pain. This included the standardization of these
techniques in consensus with the most active surgeons in the field worldwide.