RT Journal Article SR Electronic T1 Fully Implanted Prostheses for Musculoskeletal Limb Reconstruction after Amputation: An In Vivo Feasibility Study JF bioRxiv FD Cold Spring Harbor Laboratory SP 2020.07.02.184994 DO 10.1101/2020.07.02.184994 A1 Patrick T. Hall A1 Samantha Z. Bratcher A1 Caleb Stubbs A1 Rebecca E. Rifkin A1 Remi M. Grzeskowiak A1 Bryce J. Burton A1 Cheryl B. Greenacre A1 Stacy M. Stephenson A1 David E. Anderson A1 Dustin L. Crouch YR 2020 UL http://biorxiv.org/content/early/2020/07/03/2020.07.02.184994.abstract AB Previous prostheses for replacing a missing limb following amputation must be worn externally on the body. This limits the extent to which prostheses could physically interface with biological tissues, such as muscles, to enhance functional recovery. The objectives of our study were to (1) test the feasibility of implanting a limb prosthesis, or endoprosthesis, entirely within living skin at the distal end of a residual limb, and (2) identify effective surgical and post-surgical care approaches for implanting endoprostheses in a rabbit model of hindlimb amputation. We iteratively designed, fabricated, and implanted unjointed endoprosthesis prototypes in six New Zealand White rabbits following amputation. In the first three rabbits, the skin failed to heal due to dehiscence along the sutured incision. The skin of the final three subsequent rabbits successfully healed over the endoprotheses. Factors that contributed to successful outcomes included modifying the surgical incision to preserve vasculature; increasing the radii size on the endoprostheses to reduce skin stress; collecting radiographs pre-surgery to match the bone pin size to the medullary canal size; and ensuring post-operative bandage integrity. These results will support future work to test jointed endoprostheses that can be attached to muscles.Competing Interest StatementThe authors have declared no competing interest.