Innovations in Amputee Care in the United States: Access, Ethics, and Equity

Limb amputation is a growing health concern worldwide, driven largely by the rising incidence of vascular and metabolic diseases and military conflicts. In the past two decades, remarkable advancements in surgical techniques, prosthetic technologies, and rehabilitation strategies have made a profound impact on outcomes for individuals with limb loss. In this article, we explore the evolving landscape of limb care in the United States, highlighting innovations in prosthetic technology and amputation surgery including osseointegration, neuromuscular surgeries and interfaces, artificial intelligence, sensory feedback, and the importance of prosthetic embodiment. We discuss limb care systems and the continuum of limb loss rehabilitation, focusing on the need for coordinated models of patient-centered care. We present the demographic biases and healthcare disparities related to insurance coverage and reimbursement in the United States and the explore ethics and equitability considerations pertaining to prosthetic standard of care and advanced treatments for limb loss. Finally, we lay out the systemic reform, policy advocacy, and future research needed to ensure that everyone with limb loss has equitable access to the benefits of modern amputee care.