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Berberoglu et al. Plast Aesthet Res 2024;11:14 Plastic and
DOI: 10.20517/2347-9264.2023.101
Aesthetic Research

Review Open Access

Regenerative peripheral nerve interfaces (RPNIs): an
overview of innovative surgical approaches

1
1
1,2
Ipek Berberoglu , Katherine L. Burke , Paul S. Cederna , Stephen W.P Kemp 1,2
1
Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, Ann Arbor, MI 48109-0340, USA.
2
Department of Biomedical Engineering, The University of Michigan, Ann Arbor, MI 48109-5456, USA.
Correspondence to: Dr. Stephen W.P. Kemp, PhD. University of Michigan, 1150 W Medical Center Drive, Medical Sciences
Research Building II, Rm. A570A, Ann Arbor, MI 48109-5456, USA. E-mail: swpkemp@med.umich.edu
How to cite this article: Berberoglu I, Burke KL, Cederna PS, Kemp SWP. Regenerative peripheral nerve interfaces (RPNIs): an
overview of innovative surgical approaches. Plast Aesthet Res 2024;11:13. https://dx.doi.org/10.20517/2347-9264.2023.101
Received: 25 Oct 2023 First Decision: 13 Mar 2024 Revised: 26 Mar 2024 Accepted: 16 Apr 2024 Published: 24 Apr 2024

Academic Editors: Samuel O. Poore, Godard de Ruiter Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
Complications following amputation can be devastating for patients, including debilitating neuropathic pain, the
inability to perform activities of daily living (ADLs) or gain meaningful employment. While prosthesis use allows
patients to restore independence and reintegrate into daily activities, patients often abandon these devices.
Despite the immense advancements in prosthetic technology, there is still a need for an interface that can provide
a natural experience with accurate and reliable long-term control. The Regenerative Peripheral Nerve Interface
(RPNI) is a simple surgical technique that offers real-time control of myoelectric prosthetic devices to restore
extremity function. This stable, biological nerve interface successfully amplifies efferent motor action potentials,
provides sensory feedback, and offers a more functional prosthetic device experience. Based on the principles of
RPNI, novel surgical approaches have been developed to expand its applications and improve outcomes. This
review article summarizes the utilization of the RPNI and its recent modifications of different neural interfaces in
the setting of major limb amputation and musculoskeletal injuries.

Keywords: RPNI, regenerative peripheral nerve interface, targeted muscle reinnervation, amputation, prosthetic
control, exoskeleton, postamputation pain, sensory feedback

INTRODUCTION
Over 150,000 individuals undergo major limb amputations in the United States annually . Up to 80% of
[1,2]

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
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