Regenerative peripheral nerve interfaces (RPNIs): current status and future direction

Despite significant advancements in neuroprosthetic control strategies, current peripheral nerve interfacing techniques are limited in their ability to facilitate accurate and reliable long-term control. The regenerative peripheral nerve interface (RPNI) is a biologically stable bioamplifier of efferent motor action potentials with demonstrated long-term stability. This innovative, straightforward, and reproducible surgical technique has shown enormous potential in improving prosthetic control for individuals with upper limb amputations. The RPNI consists of an autologous free muscle graft secured around the end of a transected peripheral nerve or individual fascicles within a residual limb. This construct facilitates EMG signal transduction from the residual peripheral nerve to a neuroprosthetic device using indwelling bipolar electrodes on the muscle surface. This review article focuses on the development of the RPNI and its use for intuitive and enhanced prosthetic control and sensory feedback. In addition, this article also highlights the use of RPNIs for the prevention and treatment of postamputation pain