Prosthetic limbs are moving from passive substitutes toward systems that interpret motor intention, generate movement, return sensory information, and adapt through use. The central question is not whether a device looks futuristic, but whether it can become a reliable extension of embodied capability for a particular user.
A useful taxonomy keeps socket-suspended, body-powered, myoelectric, peripheral-nerve, cortical, and bone-anchored systems distinct. Osseointegration describes skeletal attachment; targeted muscle reinnervation and regenerative peripheral nerve interfaces describe biological signal strategies. None is automatically superior for every user, task, environment, or budget.
Integration is a control-loop property. Signal acquisition, decoding, actuation, feedback, rehabilitation, maintenance, and repair all matter. A device may work in a laboratory and fail in heat, fatigue, dust, or a workplace; it may improve control without reproducing ordinary sensation or becoming available through routine clinical care.
The institutional unit is therefore a maintained human-machine system involving clinicians, software providers, payers, employers, and users. Durable support, cybersecurity, informed consent, equitable financing, and the right to remain fully human whether or not a device improves productivity are part of the technology’s public value.
Sources and notes
Limitations
The controller describes a structured narrative review, not a preregistered systematic review or meta-analysis. Evidence is heterogeneous and often based on small cohorts or specialized programs.
Disclosure
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