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Amin. Plast Aesthet Res 2022;9:24 Plastic and
DOI: 10.20517/2347-9264.2021.119
Aesthetic Research

Review Open Access

Bionic limb replacement: an evolving concept in
lower extremity reconstruction

Kavit R. Amin

Division of Cell Matrix Biology & Regenerative Medicine, The University of Manchester, Manchester M13 9PL, UK.
Correspondence to: Dr. Kavit R. Amin, Division of Cell Matrix Biology & Regenerative Medicine, The University of Manchester,
Greater Manchester, Manchester M13 9PL, UK. E-mail: kavit.amin@manchester.ac.uk

How to cite this article: Amin KR. Bionic limb replacement: an evolving concept in lower extremity reconstruction. Plast Aesthet
Res 2022;9:24. https://dx.doi.org/10.20517/2347-9264.2021.119

Received: 29 Oct 2021 First Decision: 21 Jan 2022 Revised: 26 Jan 2022 Accepted: 15 Feb 2022 Published: 26 Mar 2022

Academic Editor: Matthew L Iorio Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Limb loss is disabling and carries significant functional and psychological repercussions to both the individual and
society. The numbers of amputees are forecasted to double by 2050 from vascular disease and diabetes alone.
Europe has 4.66 million amputees (431,000 amputations per year) and the United States 2 million amputees
(185,000 amputations per year). Microvascular expertise is now more commonplace, increasing the likelihood of
limb salvage and replantation. Further reconstructive input can take advantage of nerve and tendon
grafting/transfers, free tissue transfer, and complex bone reconstruction. When this strategy does not satisfy
individual needs, such as that seen with unstable soft tissues, amputation may be requested or offered. In part, the
decision for salvage, replantation, or amputation in the future is likely to be guided by the sophistication of limb
substitutes. This review will introduce the growing domain of bionics and where research in this area may deliver a
sought clinical need.

Keywords: Lower limb, lower extremity, amputation, transplantation, prosthesis, neural interface, bionic limb

INTRODUCTION
Major lower extremity trauma presents itself as one of the most complex, challenging, and multi-
disciplinary areas in the field of reconstructive surgery. This demands dedicated expertise to manage both
the acute presentation and rehabilitative process. Outcomes are causally related to the magnitude and level

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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