Bridging Bone and Nerve: U of A Surgeons Perform Canada’s First Above-Elbow Osseointegration

Chris Nielson, the first person in Canada to receive above-elbow osseointegration

In a historic milestone for Canadian medicine, University of Alberta surgeons Drs. Adil Ladak, Hollie Power and Robert Stiegelmar successfully performed Canada’s first above-elbow osseointegration surgery.

The procedure implants a titanium stem directly into the humerus, allowing a bionic limb to securely attach to the bone-anchored prosthetic and eliminating the need for a traditional socket. As part of the reconstruction, the team combined osseointegration with targeted muscle reinnervation (TMR) to optimize the interface between the patient and the prosthesis. By rerouting residual nerves to specific muscles, TMR generates meaningful muscle signals that can be detected by the prosthetic system. When paired with the direct skeletal connection provided by osseointegration, this approach creates an integrated neuromuscular and skeletal interface designed to allow more seamless and intuitive control of a myoelectric prosthetic limb.

Supported by a grant from the United States Department of Defense and led by Dr. Jacqueline S. Hebert and the BLINC Lab alongside Co-Investigators Dr. Ladak, Dr. Power and Dr. Stiegelmar, this initiative bridges surgical excellence with a multidisciplinary network spanning engineering, psychology, kinesiology, and rehabilitation. To optimize advanced prosthetic control for daily life, the team utilizes virtual reality environments and cutting-edge muscle-signal technology to train the patient and refine prosthetic control.

Clinically, the Alberta Amputation Reconstruction and Limb Osseointegration (ARLO) Program is unique in Canada and provides specialized care for individuals experiencing complex issues related to limb loss. Serving patients from across Canada, the program integrates expertise from physical medicine & rehabilitation, orthopedic surgery, plastic surgery, physical therapy, occupational therapy, and prosthetics.