Insights from the International Society for Prosthetics and Orthotics 20th World Congress

The International Society for Prosthetics and Orthotics (ISPO) hosted its annual World Congress in Stockholm in June 2025. The event showcases the very latest clinical developments, technological advancements, and scientific research for those who have suffered limb loss. The event was attended by prosthetics manufacturers, research scientists and amputee rehabilitation clinicians from across the globe.

Amputation claims have been subject to super-inflation in recent years and the event presented our amputation claims lead and serious and catastrophic injury Partner, Stephen Foster with an opportunity to learn more about the latest industry developments to assist with rehabilitation planning.

Here we provide an overview of what we consider to be the main trends and key takeaways.

Osseointegration continues to thrive outside the UK

We heard from clinicians, manufacturers and researchers based around the globe about the perceived benefits of osseointegration or bone anchored prosthetics. It is understood that clinicians in Australia have now performed the surgery on more than 1,500 amputees and that the infection rates are reducing with improvements in technology, better componentry and a more cohesive system of aftercare. This is being replicated in other parts of the world including the US where significant research is being undertaken. The surgery is available in the UK but there are a comparatively small number of amputees who have chosen to proceed with the surgery. Concerns remain about the aftercare and there is still limited information about the long term implications.

Potential technological solutions for phantom limb pain

Phantom limb pain is a perception of pain that can occur in any part of the body that no longer exists and impacts most amputees. There is a spectrum of phantom limb symptoms including tingling, numbness, itchiness, burning, cramping, shooting or stabbing pain and it can significantly impact the rehabilitation for an amputee.

There are currently several types of treatment for phantom limb pain, both non-invasive and invasive. It is a widely held view that proprioception, the brain’s awareness of the missing limb or sense of feeling the limb, can reduce phantom limb pain. There are now devices on the market that help reduce phantom limb pain for lower limb amputees such as the Suralis sensory feedback system which uses sensors in a sock like device that can be controlled via an app to essentially create a map of the lost limb at the point where the amputee receives sensory feedback.

Blind / masked limb trials

The US based Center for Limb Loss and MoBility (CLiMB) have conducted research using a prosthetic foot emulator to improve prosthetic foot prescription for individuals with lower limb loss. Participants walk on a treadmill while wearing the emulator which is programmed to simulate different foot designs effectively allowing amputees to test  devices without knowing which device is being trialled. The approach leads to well informed outcomes and could increase confidence in the limb trial process in the UK market amongst compensators if similar processes can be adopted.

New devices

We were given a demonstration of several new devices including Össur’s Navii and Blatchford’s Avior, both new microprocessor knee devices. The Navii offers very high levels of function and is suitable for those amputees keen to regain high levels of mobility. The Avior is suitable for new amputees or lower activity individuals. Both should be considered when contemplating limb trials for above knee amputees.

The new devices highlight the continued push within the prosthetics manufacturing industry to improve design and increase function for amputees. They also highlight that there is a greater choice available to amputees. Other developments such as 3D printing and the introduction of AI should also provide more variety in the market which could impact on the cost of prosthetics for the benefit of self-funded amputees and the UK compensator market.

Artificial intelligence (AI) and brain-computer interfaced technologies starting to improve performance of upper limb prosthesis
Whilst the function and dexterity of a hand remains difficult to mirror because of the complex skeletal structure, the prosthetics manufacturing industry continue to strive to close the gap and reduce the prospects of prosthetics abandonment. Advances in AI and brain-computer interfaced technologies are enabling some complex hand and arm movements to be replicated which is improving control and performance. However, there is still some way to go to replicate the dexterity of a hand.

Comment

From a UK claims perspective, these developments have the potential to improve quality of life and levels of function and independence for the amputee, which in turn could reduce overall indemnity spend for compensators.

It is clear that the fast moving prosthetics industry continues to innovate. With ongoing technological advancements, forensic research and a collaborative sharing of data we anticipate further substantial developments in the future. There are an estimated 50 million people living worldwide with limb loss and the event highlighted that there is a concerted effort within the global prosthetics industry to make functional prosthetics more accessible for all amputees.