On 21st April 2026, leading professionals in prosthetics and health economics discussed about function and health economic aspects of Microprocessor-controlled knees (MPKs).

Moderated by Prof. Dr. Bernhard Greitemann (Specialist in Orthopedics, Physical and Rehabilitation Medicine, Pain Medicine, and Technical Orthopedics) the online symposium explored both established evidence and remaining open questions regarding MPKs. While substantial evidence already demonstrates improvements in gait and a reduced frequency of falls, Greitemann emphasized the value of taking a perspective on socioeconomic outcomes. The event highlighted among others recent findings in the health economics of microprocessor knees (MPKs), providing valuable insights into their clinical and economic impact.

Safety and Reliability as the Biomechanical Foundation of Modern Knee Prosthetics.

Prof. Malte Bellmann (Director of Clinical Research & Services Germany at Ottobock SE & Co. KgaA) highlighted the necessity of safe and reliable prosthetic knee function from a biomechanical point of view. He discussed the biomechanics of gait, with particular focus on safety, outlining how different gait and movement situations place specific functional demands on prosthetic knee joints.

Bellmann emphasized that prosthetic safety is never determined by technology alone, but always results from interaction between user characteristics (condition and performance of the residual limb) and the functional properties of the prosthetic knee joint itself.

Drawing on real‑world clinical experience and scientific evidence, Bellmann pointed out that conventional indication models are being increasingly challenged. The observed outcomes show that MPKs are not solely beneficial for highly active amputees but also less for less active amptees (e.g. K2). He concluded that MPKs provide the highest level of safety regardless of the mobility level of amputees.

Health Economic Evaluation of MPKs in Western Europe.

Prof. Dr. Alexander Kuhlmann (Professor of Health Economics at the University of Lübeck, Germany) highlighted the importance of health economic evaluations as well as current findings on the health economic assessment of MPKs.

He conducted a comparative modelling study for the Dutch, German, and Swedish healthcare settings. The analysis focused on how study duration, country‑specific price levels, and health‑related quality of life influence the cost‑effectiveness of MPKs compared to Non-Microprocessor Knees (NMPKs).

Kuhlmann mentioned the substantial impact of the chosen time horizon on the incremental cost‑utility ratio (ICUR), particularly when MPKs provide sustained clinical benefits over time. After adjusting for the time horizon, higher ICUR values observed in the Netherlands were mainly driven by lower gains in quality‑adjusted life years (QALYs).

Overall, Prof. Kuhlmann concluded that, assuming sustained benefits compared with NMPKs, MPKs, such as the C-Leg or the Kenevo, may be considered cost‑effective below the threshold of €50,000 per QALY gained. His presentation provided an important contribution to the evidence‑based evaluation of advanced prosthetic technologies and their relevance for clinical and reimbursement decision‑making. (Open Access Puplication)

Economic Value of MPKs for the Medicare K2 Population.

Steven E. Heath (Senior Data Manager at Dobson DaVanzo & Associates, LLC, USA), discussed a health economic analysis on the provision of MPK for Medicare beneficiaries classified at mobility level K2, i.e., individuals with limited ability to walk outdoors.

Heath examined the impact of MPK coverage compared with NMPK in a US setting. The analysis presented assessed outcomes in terms of Medicare expenditures per member per month as well as the incidence of falls resulting in a medical claim. The findings indicate that providing MPKs to K2 beneficiaries may lead to both economic benefits for Medicare and improved clinical outcomes for patients.

According to Heath, it takes 19 months for the adjusted cost difference of USD 25,075 associated with MPK provision to amortize. Furthermore he noted an 18.5 percent reduction in individuals experiencing falls that resulted in a medical claim, suggesting improved mobility and quality of life within the K2 population. The provision of MPKs to K2 beneficiaries could generate Medicare cost savings of approximately USD 410.3 million over a ten-year period, he noted.

In summary, Heath demonstrated that MPK provision for the Medicare K2 population may not only benefit amputees themselves but also result in cost savings to the Medicare program overall. This study adds to the literature supporting evidence-based coverage decisions in prosthetic care.

Wrap up.

The recent online symposium provided valuable insights into real-world biomechanical evidence and current health economic findings related to MPKs.

In his concluding remarks, Prof. Dr. Greitemann underscored that microprocessor-controlled knees not only improve gait, reduce the frequency of falls, and enhance quality of life and social participation, but also demonstrate clear cost benefits, supporting their value from both a clinical and an economic perspective.

To view the recording of the symposium, please click on this link: Prosthetic Symposium. The value of microprocessor controlled knees. | Ottobock Professionals - YouTube. The recording is available until 30th July 2026.