Editor’s Note–October 2025

While no one would describe any prosthesis as simple, the general requirements of a lower-limb prosthesis are fairly straightforward—enable weight bearing, provide stability, and restore mobility for the user. Upper-limb prostheses, however, are more complicated because of the characteristics of the limbs they are meant to replace. Upper limbs have a greater range of motion and the ability to perform gross and fine motor skills. Beyond that, we use them to communicate through gestures. In this issue, we explore aspects of upper-limb care and future advancements.

Over the last few years, as the OPRA system gained full approval from the US Food and Drug Administration (FDA), lower-limb osseointegration (OI) has become more mainstream for people who struggle with socket-based prostheses. Upper-limb OI, which is still in trials and largely available in the US only under the FDA’s compassionate use protocols, is much less familiar. Though the basic surgical procedure is the same, the rehabilitation process and prosthetic training differ between people with upper- and lower-limb amputations. Additionally, research in progress is exploring novel control mechanisms using wires connected through the implant. Experts discuss the opportunities OI can offer in “Upper-Limb Osseointegration: Connections on a Higher Plane.”