A female Swedish patient with hand amputation has become the first recipient of an osseo-neuromuscular implant to control a dexterous hand prosthesis. Titanium implants were placed in the two forearm bones (radius and ulnar), from which electrodes to nerves and muscle were extended to extract signals to control a robotic hand and to provide tactile sensations. This makes it the first clinically viable, dexterous,s and sentient prosthetic hand usable in real life. The breakthrough is part of the European project DeTOP.

The new implant technology was developed in Sweden by a team lead by Dr. Max Ortiz Catalan at Integrum AB – the company behind the first bone-anchored limb prosthesis using osseointegration – and Chalmers University of Technology. This first-of-its-kind surgery, led by Prof. Rickard Brånemark and Dr. Paolo Sassu, took place at Sahlgrenska University Hospital as part of a larger project funded by the European Commission under Horizon 2020 called DeTOP (GA #687905).

The DeTOP project is coordinated by Prof. Christian Cipriani at the Scuola Superiore Sant’Anna, and also includes Prensilia, the University of Gothenburg, Lund University, University of Essex, the Swiss Center for Electronics and Microtechnology, INAIL Prosthetic Center, Università Campus Bio-Medico di Roma, and the Instituto Ortopedico Rizzoli.

Conventional prosthetic hands rely on electrodes placed over the skin to extract control signals from the underlying stump muscles. These superficial electrodes deliver limited and unreliable signals that only allow control of a couple of gross movements (opening and closing the hand). Richer and more reliable information can be obtained by implanting electrodes in all remaining muscle in the stump instead. Sixteen electrodes were implanted in this first patient in order to achieve more dexterous control of a novel prosthetic hand developed in Italy by the Scuola Superiore Sant’Anna and Prensilia.

Current prosthetic hands have also limited sensory feedback. They do not provide tactile or kinesthetic sensation, so the user can only rely on vision while using the prosthesis. Users cannot tell how strongly an object is grasped, or even when contact has been made. By implanting electrodes in the nerves that used to be connected to the lost biological sensors of the hand, researchers can electrically stimulate these nerves in a similar manner as information conveyed by the biological hand. This results in the patient perceiving sensations originating in the new prosthetic hand, as it is equipped with sensors that drive the stimulation of the nerve to deliver such sensations. 

One of the most important aspects of this work is that this is the first technology usable in daily life. This means it is not limited to a research laboratory. The Swedish group – Integrum AB and Chalmers University of Technology – have previously demonstrated that control of a sentient prosthesis in daily life was possible in above-elbow amputees using similar technology. This was not possible in below-elbow amputees where there are two smaller bones rather than a single larger one as in the upper arm. This posed several challenges on the development of the implant system. On the other hand, it also presents an opportunity to achieve a more dexterous control of an artificial replacement. This is because many more muscles are available to extract neural commands in below-elbow amputations.

Bones weaken if they are not used (loaded), as commonly happens after amputation. The patient is following a rehabilitation program to regain the strength in her forearm bones to be able to fully load the prosthetic hand. In parallel, she is also relearning how to control her missing hand using virtual reality.In a few weeks, she will be using a prosthetic hand with increasing function and sensations in her daily life. Two more patients will be implanted with this new generation of prosthetic hand in the upcoming months, in Italy and Sweden.

The attachment to the body of a robotic limb is a major problem when attempting to replace a lost extremity. The most common approach is using a socket over the stump, which often causes discomfort, pain, and limits mobility, in between other problems. The new technology does not require a socket and, instead, relays on the integration of bone tissue and titanium to anchor the prosthesis directly to the skeleton via a prosses call osseointegration.

Osseointegration was discovered in Sweden in the 1950s, used first to enable dental implants in the 1960s and then, since the 1990s, for anchoring limb prostheses – a technology pioneered by Integrum AB. This technology is now further applied as a communication interface to electrodes implanted in nerves and muscles to provide control over the prosthesis in additional skeletal attachment. In below-elbow amputations, this technology has the additional advantage to allow for natural wrist rotation, thus restoring one additional motion with natural control and sensory feedback. 

“Several advanced prosthetic technologies have been reported in the last decade, but unfortunately they have remained as research concepts used only for short periods of time in controlled environments,” says Dr. Ortiz Catalan, who has led this development since its beginning 10 years ago initially in above-elbow amputations. “The breakthrough of our technology consists of enabling patients to use implanted neuromuscular interfaces to control their prosthesis while perceiving sensations where it matters for them, in their daily life.”

Fremont, California – Confluent Medical (formerly Nitinol Devices & Components NDC) launched the High-Performance Nitinol Tubing Center of Excellence in response to increasing market demand for high-performance nitinol tubing in challenging applications such as transcatheter heart valves, neurovascular, electrophysiology, and interventional pulmonary. Confluent Medical is able to support the Nitinol component manufacturers that require the highest performance in Nitinol durability, fatigue-resistance, surface finish, and tight tolerances.

The High-Performance Nitinol Tubing Center of Excellence has world-class internal capabilities that include:

• High purity ELI Nitinol material – Custom-melted Nitinol material with exceptionally high purity that provides superior cyclical fatigue durability
• Wide range of Nitinol tubing sizes and tolerances – Nitinol tubing in diameters that exceed 10mm, which is often used in complex transcatheter mitral or aortic valve components
• Precise Nitinol tubing processes, including gun-drilling, centerless grinding, and machining – With the recent acquisition of Tube Hollows International, Confluent Medical has the most comprehensive, best-in-class offering for Nitinol tubing processing
• Superior surface finish – An optimal surface on the OD and ID that allows for ideal component manufacturing

The acquisition of Tube Hollows International (THI) has been a key piece in the development of the High-Performance Nitinol Tubing Center of Excellence. THI is the leader in precision gun-drilling of Nitinol tube hollows. Additionally, THI brings world-class capabilities in centerless grinding and precision machining.

Confluent Medical’s High-Performance Nitinol Tubing Center of Excellence is ideally set up to support medical device companies that require world-class Nitinol tubing for their designs for long-term implantable applications within the heart and other critical structures.

Solvay's Radel PPSU resin helped Legacy Medical Solutions optimize a large-format sterilization tray for surgical instruments. Radel polyphenylsulfone (PPSU) resin’s strength-to-weight ratio, ability to withstand high pH cleaners during repeated sterilization cycles and high-temperature autoclaves were key factors in Legacy Medical Solutions’ decision to utilize the material to improve the design, manufacture and use of the tray.

Legacy Medical Solutions’ unique sterilization tray, measuring 23.5" x 15.0" x 5.6" (59.7cm x 38.1cm x 14.2cm) is comprised of a thermoformed Radel PPSU transparent lid and an opaque base tray that secures with a metal clamping system. The transparent lid provides visibility of the tray’s contents for added convenience. The base tray weighs up to 50% lighter than competitive models fashioned with anodized aluminum, a traditional material of choice, and features large drilled holes for effective venting during sterilization. Radel PPSU resin also provides the tray with superior impact strength, flexibility and chemical resistance. Importantly, the material is compatible with various sterilization methods, including autoclaving at 280°F (138°C) for sustained periods of time, demonstrating exceptional toughness and maintaining excellent aesthetics. 

“Today’s sterilization trays need to withstand punishing autoclaving protocols with high pH cleaners, through hundreds of sterilization cycles,” says Joel S. Hughes, president of Legacy Medical Solutions. “Anodized aluminum trays can fade quickly after just one sterilization cycle if treated with high pH cleaners, but the trays we make with Radel PPSU retain their fresh appearance thanks to the material’s superior chemical and heat resistance.”

Legacy Medical Solutions also selected Solvay’s Radel PPSU because this high-performance, medical grade polymer supports the design and manufacture of a customizable platform. Through the addition of an innovative bracket, multiple insert plates can be used, and the number of sterilization validations can be reduced. Radel PPSU resin further enables product customization due to its availability in a variety of transparent and opaque colors that can support customer corporate branding efforts.

“Solvay’s commitment to innovative product development is demonstrated through its collaboration and technical support for leaders like Legacy Medical Solutions,” notes Dane Waund, global marketing manager for healthcare at Solvay’s Specialty Polymers global business unit. “With this large-format sterilization tray, Solvay’s Radel PPSU resin is enabling dramatic design improvements, supporting a variety of manufacturing methods, and ensuring superior performance and a longer product life.”

St. Paul, Minnesota – Matsuura Machinery USA Inc. will host the IMAGINE.CREATE.INNOVATE. open house at its St. Paul, Minnesota, facility April 23-24, 2019 from 10:00am to 4:00pm. At the event, Matsuura will debut the company’s latest machines, the MAM72-70V, a high speed, large capacity 5-axis vertical machining center and the MX-850 PC4, an automated version of the large capacity 5-axis vertical machining center.

Technology seminars
“Matsuura USA will feature technology seminars, machine tool accessory vendors, and applications and service experts, providing engineering solutions for your manufacturing challenges. Learn what Matsuura’s knowledgeable and experienced speakers have done to make their business so successful. Invest in yourself and your company, be inspired and motivated to reach the same level of success,” says Matsuura USA President, Craig St. John.

Contact your exclusive Matsuura distributor or events@matsuurausa.com to register.

Matsuura Machinery USA will also showcase the following machines at the open house:

• CUBLEX-35 5-axis multi-tasking machining center with turning and grinding capability equipped with a 32-pallet tower and a 3,200-tool matrix magazine
• H.Plus-504 horizontal machining center (HMC) outfitted with 500mm x 500mm pallet and #40-taper spindle
• H.Plus-630 high performance machining center designed for hard metal cutting with a standard 12,000rpm spindle offering 451N•m of torque
• LF-160 linear motor machine for high-speed, high-precision machining of smaller workpieces employing linear motor technology
• MX-330 5-axis vertical machining center (VMC) configured with 10 pallets and 90 tools providing unmanned 5-axis production using a standard Matsuura-made 15,000rpm spindle with 119.3N•m of torque
• MX-520 PC4 5-axis vertical machining center (VMC) outfitted with 90 tools, 4-pallet changer, and Matsuura MAXIA 12,000rpm high-torque spindle
• Matsuura LUMEX Avance-25 metal laser sintering hybrid milling machine
• Matsuura LUMEX Avance-60 metal laser sintering hybrid milling machine

© Matsuura | http://matsuurausa.com

Open house debuts, demos
Matsuura USA chose this year’s theme for the open house, IMAGINE.CREATE.INNOVATE., based on Matsuura Corp. President, Katsutoshi Matsuura.

He describes how this slogan inspires him because, “My Grandfather Imagined what Matsuura could become. My Father Created it. And I have Innovated it.”

Making its North American debut, the MAM72-70V, a high speed, large capacity 5-axis vertical machining center:

“The MAM72-70V is designed to handle a greater workpiece size than Matsuura’s existing models, offers faster response times to the market, and delivers an even higher productivity to meet customers’ business requirements for faster cycle times and cost down performance,” says David Hudson, Matsuura Machinery USA vice president of sales and marketing.

The MAM72-70V features a maximum workpiece of 700mm x 500mm (DxH) with a load capacity of 500kg per pallet; an 11% increase in diameter/height; 43% increase in weight; and 38% increase in envelope volume as compared to the MAM72-63V.

The MAM72-70V includes a newly developed 4th/5th axis table equipped with a proven roller gear drive for the 4th axis and direct drive motor for the 5th axis. These enhancements achieve a rapid traverse rate of 50 min^-1 and 100 min^-1 respectively, enabling high speed, high accuracy and durability in extended performance over the lifetime of the machine.

By improving the MAM72 structure, improved ergonomic operator access and ease of operation for setup and maintenance are assured. The distance from the machine front (oil pan edge) to the pallet center is now only 620mm.

“Unmatched in performance, and the globally trusted go-to platform for a variety of precision led industries, the MAM72 Series enhances cost-savings and provides better positioning, while delivering pallet and productivity solutions to keep your work center efficiently producing components around the clock,” Hudson adds.

The MAM72-70V is Internet of Things (IoT) ready, delivering measurable remote and real time monitoring of the machine status, condition and performance. IoT, the internet of things, is a system of interrelated computing devices, mechanical and digital machines, objects, animals or people that are provided with unique identifiers (UIDs) and the ability to transfer data over a network without requiring human-to-human or human-to-computer interaction.

Matsuura USA will also introduce the MX-850 PC4, an automated version of the large capacity 5-axis vertical machining center:

© Matsuura | http://matsuurausa.com

“With cost down pressures on all manufacturers, the need for reliable automated machining is increasing globally in both established and emerging markets,” Hudson explains.

The MX-850 PC4 is outfitted with 90 tools and a load capacity per pallet of 500kg. Additionally, the MX-850 PC4 has a standard installed Universal Robot interface to maximize the automation potential.

The MX-850 brings cutting power and Matsuura 5-axis high speed to within reach of every company. From aluminum to hard to cut materials, the MX-850 manages sizable and multifaceted machining tasks.

Developed in response to market demand for a large capacity, high-quality, yet cost-effective, single-table Matsuura 5-axis machining platform, the MX-850 is compactly built, yet ensures high rigidity and a sufficient machining area and workability.

The MX-850 is equipped with Matsuura’s proven operating system optimizing performance, automation and spindle utilization. The operating system permits direct, instinctive control as well as Matsuura Intelligent Meister System (MIMS) and Matsuura’s proprietary Intelligent Protection System for the prevention of collisions.

“At Matsuura, we have developed machining centers with large pallet pools to achieve lights-out manufacturing with size ranges never before available in the Matsuura family of 5-axis machining centers. Matsuura’s automated pallet pool machining solutions achieve more production, offering higher levels of spindle optimization and machine utilization,” Hudson adds.

Contact your exclusive Matsuura distributor or events@matsuurausa.com to register