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Related Experiment Video

Updated: Jan 11, 2026

Engineering Platform and Experimental Protocol for Design and Evaluation of a Neurally-controlled Powered Transfemoral Prosthesis
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Health economic evaluation of microprocessor and non-microprocessor controlled prosthetic knees.

C E Bosman1, C K van der Sluis1, A H Vrieling1

  • 1Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Canadian Prosthetics & Orthotics Journal
|November 17, 2025
PubMed
Summary
This summary is machine-generated.

Microprocessor-controlled knees (MPKs) offer improved prosthesis-related quality of life but at significantly higher costs than non-microprocessor-controlled knees (NMPKs). The short-term gains in health-related quality of life do not justify the increased expense based on Dutch willingness-to-pay thresholds.

Keywords:
AmputationCost AnalysisCost-effectivenessKnee DisarticulationLower LimbMicroprocessor KneeMobilityProsthesesQuality of LifeQuestionnaireTransfemoral

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Area of Science:

  • Prosthetics and Orthotics
  • Health Economics
  • Rehabilitation Engineering

Background:

  • Microprocessor-controlled knees (MPKs) may enhance walking ability and user satisfaction compared to non-microprocessor-controlled knees (NMPKs).
  • The higher acquisition cost of MPKs raises questions about their cost-effectiveness relative to NMPKs.

Purpose of the Study:

  • To conduct a cost-utility and cost-effectiveness analysis of MPKs versus NMPKs.
  • To evaluate these prosthetic options from a societal perspective within the Netherlands.

Main Methods:

  • Utilized the EuroQol five dimensions five levels (EQ-5D-5L) for health-related quality of life.
  • Employed the Prosthesis Evaluation Questionnaire (PEQ) for prosthesis-specific quality of life.
  • Calculated Incremental Cost-Utility Ratio (ICUR) and Incremental Cost-Effectiveness Ratio (ICER), comparing ICUR to the Dutch willingness-to-pay threshold.

Main Results:

  • MPK use resulted in a mean increase of 0.032 Quality Adjusted Life Years (QALYs) at an additional cost of €14,626.
  • The mean ICUR was €457,063 per QALY gained, significantly exceeding willingness-to-pay thresholds.
  • Cost differences were primarily driven by acquisition costs, though partially offset by reduced work absence and healthcare utilization.

Conclusions:

  • MPKs demonstrate potential for improved prosthesis-specific quality of life but incur substantial additional costs.
  • Short-term improvements in health-related quality of life were insufficient to offset MPK costs.
  • The high ICUR suggests MPKs are not cost-effective within the Dutch healthcare system's established thresholds based on this 6-month evaluation.