Bionic limbs: clinical reality and academic promises.

Three recent articles in Science Translational Medicine (Tan et al. and Ortiz-Catalan et al., this issue; Raspopovic et al., 5 Feb 2014 issue, 222ra19) present neuroprosthetic systems in which sensory information is delivered through direct nerve stimulation while controlling an action of the prosthesis--in all three cases, arm and hand movement. We discuss such sensory-motor integration and other key issues in prosthetic reconstruction, with an emphasis on the gap existing between clinically available systems and more advanced, custom-designed academic systems. In the near future, osseointegration, implanted muscle, and nerve electrodes for decoding and stimulation may be components of prosthetic systems for clinical use, available to a large patient population.