Recent Advancements, Trends and Future Prospects of Upper Limb Prosthesis through 3D printing- A Systematic Review
DOI:
https://doi.org/10.65904/3083-3604.2026.02.01Keywords:
Upper limb prosthesis, 3D printing, Additive manufacturing, Myoelectric control, Electromyography (EMG), Sensor integration, Smart prostheticsAbstract
New opportunities for personalised, functional, and affordable rehabilitation interventions have been made possible through the use of smart technologies in the design of prosthetic limbs. Prosthetic devices have had customisation and affordability revolutionised by 3D printing, but the integration of additive manufacturing with embedded sensors and adaptive control systems is still an emerging and exciting discipline. Conceptualization, development, and integration of embedded sensors for real-time evaluation, biomechanical feedback, and user-controlled algorithms are the subject of this review paper, which systematically explores the state-of-the-art of smart 3D-printed prosthetics. Important technologies augmenting prosthesis performance and user experience, including force and pressure sensors, electromyography (EMG) interfaces, inertial measurement units (IMUs), and soft robotics, are elaborated. For the creation of fully intelligent prosthetic systems, the article addresses major gaps that should be filled and identifies current developments and technical hurdles in the areas of biocompatibility, computational signaling, strength, and power management. The article concludes by pointing out that cross-disciplinary collaboration among materials science, biomedical engineering, robotics, and artificial intelligence is necessary to develop fully integrated, autonomous, and low-cost smart prostheses. Furthermore, the review highlights sustainability-driven advantages of 3D-printed prosthetics, including material efficiency, recyclability of thermoplastics, low-power sensing architectures, and environmentally responsible, low-cost manufacturing pathways.
References
A. D. Roche, H. Rehbaum, D. Farina, and O. C. Aszmann, “Prosthetic Myoelectric Control Strategies: A Clinical Perspective,” Curr Surg Rep, vol. 2, no. 3, Mar. 2014.
J. ten Kate, G. Smit, and P. Breedveld, “3D-printed upper limb prostheses: a review,” Apr. 03, 2017, Taylor and Francis Ltd.
J. Zuniga et al., “Cyborg beast: A low-cost 3d-printed prosthetic hand for children with upper-limb differences,” BMC Res Notes, vol. 8, no. 1, Dec. 2015.
J. ten Kate, G. Smit, and P. Breedveld, “3D-printed upper limb prostheses: a review,” Apr. 03, 2017, Taylor and Francis Ltd.
“Limb amputation and limb deficiency: epidemiology and recent trends in the United States”. “Inspiratory muscle fatigue in trained cyclists: effects of inspiratory muscle training”.
L. Resnik et al., “Advanced upper limb prosthetic devices: Implications for upper limb prosthetic rehabilitation,” 2012, W.B. Saunders. “Synopsis of Causation Upper Limb Amputation,” 2008.
H. Huang et al., “CHI3L1 is a liver-enriched, noninvasive biomarker that can be used to stage and diagnose substantial hepatic fibrosis,” OMICS, vol. 19, no. 6, pp. 339–345, Jun. 2015.
B. Alexander Miles and F. Edin, “Two Cases of Traumatic Epilepsy Treated by Trephining.”
F. M. Alshehri, S. A. Ahmed, S. Ullah, H. Ghazal, S. Nawaz, and A. S. Alzahrani, “The Patterns of Acquired Upper and Lower Extremity Amputation at a Tertiary Centre in Saudi Arabia,” Cureus, Apr. 2022.
A. A. Mousavi, A. R. Saied, and E. Heidari, “A survey on causes of amputation in a 9-year period in Iran,” Arch Orthop Trauma Surg, vol. 132, no. 11, pp. 1555–1559, Nov. 2012.
L. Resnik, S. Ekerholm, M. Borgia, and M. A. Clark, “A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings,” PLoS One, vol. 14, no. 3, Mar. 2019.
T. J. Geraghty and L. E. Jones, “Painful neuromata following upper limb amputation,” 1996.
G. H. Kejlaa, “Consumer concerns and the functional value of prostheses to upper limb amputees,” 1993.
K. Østlie, R. J. Franklin, O. H. Skjeldal, A. Skrondal, and P. Magnus, “Musculoskeletal pain and overuse syndromes in adult acquired major upper-limb amputees,” Arch Phys Med Rehabil, vol. 92, no. 12, 2011.
K. A. Raichle et al., “Prosthesis use in persons with lower-and upper-limb amputation.”
M. A. Hanley, D. M. Ehde, M. Jensen, J. Czerniecki, D. G. Smith, and L. R. Robinson, “Chronic pain associated with upper-limb loss,” Am J Phys Med Rehabil, vol. 88, no. 9, pp. 742–751, Aug. 2016.
C. M. Kooijman, P. U. Dijkstra, J. H. B. Geertzen, A. Elzinga, and C. P. Van Der Schans, “Phantom pain and phantom sensations in upper limb amputees: An epidemiological study,” Pain, vol. 87, no. 1, pp. 33–41, Jul. 2000.
D. Segura, E. Romero, V. E. Abarca, and D. A. Elias, “Upper Limb Prostheses by the Level of Amputation: A Systematic Review,” Apr. 01, 2024, Multidisciplinary Digital Publishing Institute (MDPI).
A. S. Sarvestani and A. T. Azam, “Amputation: A ten-year survey,” Trauma Mon, vol. 18, no. 3, pp. 126–129, 2013.
J. Settakorn, S. Rangdaeng, O. Arpornchayanon, S. Lekawanvijit, L. Bhoopat, and J. Attia, “Why were limbs amputated? An evaluation of 216 surgical specimens from Chiang Mai University Hospital, Thailand,” Arch Orthop Trauma Surg, vol. 125, no. 10, pp. 701–705, Dec. 2005.
C. N. Mock, E. Boland, F. Acheampong, and S. Adjei, “Long-term injury related disability in Ghana,” Disabil Rehabil, vol. 25, no. 13, pp. 732–741, Jul. 2003.
V. H. Nagaraja, J. H. M. Bergmann, D. Sen, and M. S. Thompson, “Examining the needs of affordable upper limb prosthetic users in India: A questionnairebased survey,” 2016, IOS Press.
V. Shandilya, L. Parmar, and A. Shandilya, “Lower Limb Amputations in Central Gujarat: A Retrospective Analysis of Multiple Camps,” Journal of Integrated Health Sciences, vol. 8, no. 2, p. 78, 2020.
G. P. Reddy, P. S. Hari, S. Sahu, M. Kumar, C. K. Varma, and V. Goyal, “Limb Amputations in a Tertiary Care Hospital, North India: A Cross-sectional Epidemiological Study – Can We Prevent This?,” Journal of Marine Medical Society, Feb. 2024.
M. Saaiq, “Epidemiology and outcome of childhood electrical burn injuries at Pakistan Institute of Medical Sciences Islamabad, Pakistan,” Journal of Burn Care and Research, vol. 37, no. 2, pp. e174–e180, 2016.
J. S. Ro, J. H. Leigh, I. Jeon, and M. S. Bang, “Trends in burden of work-related upper limb amputation in South Korea, 2004-2013: A nationwide retrospective cohort study,” BMJ Open, vol. 9, no. 11, Nov. 2019.
S. C. Maguire et al., “Trends and outcomes of non-traumatic major lower extremity amputations in an Irish tertiary referral hospital,” Ir J Med Sci, vol. 189, no. 4, pp. 1351–1358, Nov. 2020.
M. Asif et al., “Advancements, Trends and Future Prospects of Lower Limb Prosthesis,” IEEE Access, vol. 9, pp. 85956–85977, 2021.
L. Resnik, S. Ekerholm, M. Borgia, and M. A. Clark, “A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings,” PLoS One, vol. 14, no. 3, Mar. 2019.
O. Onwuasoigwe, I. C. Okwesili, L. O. Onyebulu, E. C. Nnadi, and A. D. G. Nwosu, “Lower Limb Amputations in Nigeria,” International Journal of Medicine and Health Development, vol. 26, no. 1, pp. 64–69, Jan. 2021.
S. R. Husein, M. Naidoo, H. Bougard, and K. M. Chu, “Long-term mortality after lower extremity amputation: A retrospective study at a second-level government hospital in Cape Town, South Africa,” East Cent Afr J Surg, vol. 26, no. 1, pp. 1–5, Jan. 2021.
S. L. Mitchell, R. Hayda, A. T. Chen, A. R. Carlini, J. R. Ficke, and E. J. Mackenzie, “The Military Extremity Trauma Amputation/Limb Salvage (METALS) Study: Outcomes of Amputation Compared with Limb Salvage Following Major Upper-Extremity Trauma,” Journal of Bone and Joint Surgery - American Volume, vol. 101, no. 16, pp. 1470–1478, Aug. 2019.
G. Mattiassich et al., “Long-term outcome following upper extremity replantation after major traumatic amputation,” BMC Musculoskelet Disord, vol. 18, no. 1, Feb. 2017.
T. Melcer et al., “A Retrospective Comparison of Five-Year Health Outcomes Following Upper Limb Amputation and Serious Upper Limb Injury in the Iraq and Afghanistan Conflicts,” PM and R, vol. 11, no. 6, pp. 577–589, Jun. 2019.
A. M. Jarc, A. B. Kimes, M. E. Pearson, and M. A. Peck, “The Design and Control of a Low-Power, Upper-Limb Prosthesis.”
C. Radu, M. M. Rosu, L. Matei, L. M. Ungureanu, and M. Iliescu, “Concept, design, initial tests and prototype of customized upper limb prosthesis,” Applied Sciences (Switzerland), vol. 11, no. 7, Apr. 2021.
N. Omarkulov, K. Telegenov, M. Zeinullin, A. Begalinova, and A. Shintemirov, “Design and analysis of an underactuated anthropomorphic finger for upper limb prosthetics,” in Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS, Institute of Electrical and Electronics Engineers Inc., Nov. 2015, pp. 2474–2477.
F. G 1/2 3/4•rski, P. Zawadzki, R. Wichniarek, W. Kuczko, S. Slupinska, and M. Zukowska, “Automated Design and Rapid Manufacturing of Low-Cost Customized Upper Limb Prostheses,” in Journal of Physics: Conference Series, Institute of Physics, 2022. “Mechanical_designs_of_active_upper_limb”.
D. A. Saqib, U. Arif, J. Z. Islam, and M. Qasim, “Prosthetic Arm and Hand Design,” International Journal of Materials, Mechanics and Manufacturing, vol. 6, no. 4, pp. 273–276, Aug. 2018.
V. A. Yurova, G. Velikoborets, and A. Vladyko, “Design and Implementation of an Anthropomorphic Robotic Arm Prosthesis,” Technologies (Basel), vol. 10, no. 5, Oct. 2022.
A. Demofonti, G. Carpino, N. L. Tagliamonte, G. Baldini, L. Bramato, and L. Zollo, “Design of a modular and compliant wrist module for upper limb prosthetics,” Anatomical Record, vol. 306, no. 4, pp. 764–776, Apr. 2023.
C. Lake, “The Evolution of Upper Limb Prosthetic Socket Design,” 2008.
F. Mereu, F. Leone, C. Gentile, F. Cordella, E. Gruppioni, and L. Zollo, “Control strategies and performance assessment of upper-limb tmr prostheses: A review,” Mar. 02, 2021, MDPI AG.
S. L. Carey, D. J. Lura, and M. J. Highsmith, “Differences in Myoelectric and Body-Powered Upper-Limb Prostheses: Systematic Literature Review,” JPO Journal of Prosthetics and Orthotics, vol. 29, no. 4S, pp. P4–P16, Oct. 2017.
G. S. Rash, “Electromyography Fundamentals.”
D. P. McMullen et al., “Demonstration of a semi-autonomous hybrid brain-machine interface using human intracranial EEG, eye tracking, and computer vision to control a robotic upper limb prosthetic,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 22, no. 4, pp. 784–796, 2014.
S. Gupta, H. J. Lee, K. J. Loh, M. D. Todd, J. Reed, and A. Drew Barnett, “Noncontact strain monitoring of osseointegrated prostheses,” Sensors (Switzerland), vol. 18, no. 9, Sep. 2018.
L. Trent et al., “A narrative review: current upper limb prosthetic options and design,” Aug. 17, 2020, Taylor and Francis Ltd.
D. Brenner et al., “Members of the Canadian Cancer Statistics Advisory Committee Analytic leads Additional analysis Project management,” 2021.
P. Capsi-Morales et al., “Functional assessment of current upper limb prostheses: An integrated clinical and technological perspective,” PLoS One, vol. 18, no. 8 August, Aug. 2023.
M. A. Battraw, J. Fitzgerald, W. M. Joiner, M. A. James, A. M. Bagley, and J. S. Schofield, “A review of upper limb pediatric prostheses and perspectives on future advancements,” Jun. 01, 2022, Lippincott Williams and Wilkins.
W. Paper, G. Mcgimpsey, and T. C. Bradford, “Limb Prosthetics Services and Devices Critical Unmet Need: Market Analysis.”
A. Prakash, B. Kumari, and S. Sharma, “A low-cost, wearable sEMG sensor for upper limb prosthetic application,” J Med Eng Technol, vol. 43, no. 4, pp. 235–247, May 2019.
A. Tiele et al., “Design and development of a novel upper-limb cycling prosthesis,” Bioengineering, vol. 4, no. 4, Dec. 2017.
J. Tang, X. Liu, Z. Liu, and W. Li, “Optimal design and 3D printing of prosthetic socket based on the interface pressure between the socket and residual limb,” Prosthet Orthot Int, vol. 47, no. 1, pp. 87–93, Feb. 2023.
W. Farah, N. Iwani, W. Ikeramzamani, A. Anwar, and S. Sidek, “Modular Joint Using 3D Printer for Compact House in Klang Valley Area,” Wan Ikeramzamani & Sidek, vol. 4, no. 2, pp. 241–255, 2023.
F. Górski, R. Wichniarek, W. Kuczko, and M. Żukowska, “Study on properties of automatically designed 3d-printed customized prosthetic sockets,” Materials, vol. 14, no. 18, Sep. 2021.
A. Cabrera et al., “Prosthetic Sockets: Tensile Behavior of Vacuum Infiltrated Fused Deposition Modeling Sandwich Structure Composites,” Prosthesis, vol. 4, no. 3, pp. 317–337, Sep. 2022.
M. Ahmed, “University of Debrecen Faculty of Engineering Department of Mechanical Engineering.”
W. D. Lestari et al., “Optimization of 3D printed parameters for socket prosthetic manufacturing using the taguchi method and response surface methodology,” Results in Engineering, vol. 21, Mar. 2024.
W. Paper, G. Mcgimpsey, and T. C. Bradford, “Limb Prosthetics Services and Devices Critical Unmet Need: Market Analysis.”
D. Brenner et al., “Members of the Canadian Cancer Statistics Advisory Committee Analytic leads Additional analysis Project management,” 2021.
M. A. Battraw, J. Fitzgerald, W. M. Joiner, M. A. James, A. M. Bagley, and J. S. Schofield, “A review of upper limb pediatric prostheses and perspectives on future advancements,” Jun. 01, 2022, Lippincott Williams and Wilkins.
A. Tiele et al., “Design and development of a novel upper-limb cycling prosthesis,” Bioengineering, vol. 4, no. 4, Dec. 2017.
P. Capsi-Morales et al., “Functional assessment of current upper limb prostheses: An integrated clinical and technological perspective,” PLoS One, vol. 18, no. 8 August, Aug. 2023.
A. Prakash, B. Kumari, and S. Sharma, “A low-cost, wearable sEMG sensor for upper limb prosthetic application,” J Med Eng Technol, vol. 43, no. 4, pp. 235–247, May 2019.
C. L. Taylor, “The Biomechanics of Control in Upper-Extremity Prostheses.”
P. R. Culmer et al., “A control strategy for upper limb robotic rehabili-tation with a dual robot system,” IEEE/ASME Transactions on Mechatronics, vol. 15, no. 4, pp. 575–585, Aug. 2010.
P. E. Crago, N. Lan, P. H. Veltink, J. J. Abbas, and C. Kantor, “Department of Veterans Affairs New control strategies for neuroprosthetic systems,” 1996.
J. Hahne, C. Prahm, I. Vujaklija, and D. Farina, “Control strategies for functional upper limb prostheses,” in Bionic Limb Reconstruction, Springer International Publishing, 2021, pp. 127–135.
K. Ohnishi, R. F. Weir, and T. A. Kuiken, “Neural machine interfaces for controlling multifunctional powered upper-limb prostheses,” Jan. 2007.
F. Mereu, F. Leone, C. Gentile, F. Cordella, E. Gruppioni, and L. Zollo, “Control strategies and performance assessment of upper-limb tmr prostheses: A review,” Mar. 02, 2021, MDPI AG.
Y. Gloumakov, J. Bimbo, and A. M. Dollar, “Trajectory Control for 3 Degree-of-Freedom Wrist Prosthesis in Virtual Reality: A Pilot Study,” in Proceedings of the IEEE RAS and EMBS International Conference on Biomedical Robotics and Biomechatronics, IEEE Computer Society, Nov. 2020, pp. 765–772.
W. Guo, X. Sheng, H. Liu, and X. Zhu, “Toward an Enhanced Human-Machine Interface for Upper-Limb Prosthesis Control with Combined EMG and NIRS Signals,” IEEE Trans Hum Mach Syst, vol. 47, no. 4, pp. 564–575, Aug. 2017.
J. Ma, N. V. Thakor, and F. Matsuno, “Hand and wrist movement control of myoelectric prosthesis based on synergy,” IEEE Trans Hum Mach Syst, vol. 45, no. 1, pp. 74–83, Feb. 2015.
M. Controzzi, F. Clemente, D. Barone, A. Ghionzoli, and C. Cipriani, “The SSSA-MyHand: A dexterous lightweight myoelectric hand prosthesis,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 25, no. 5, pp. 459–468, May 2017.
A. Ninu, S. Dosen, S. Muceli, F. Rattay, H. Dietl, and D. Farina, “Closed-loop control of grasping with a myoelectric hand prosthesis: Which are the relevant feedback variables for force control?,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 22, no. 5, pp. 1041–1052, Sep. 2014.
M. Schiefer, D. Tan, S. M. Sidek, and D. J. Tyler, “Sensory feedback by peripheral nerve stimulation improves task performance in individuals with upper limb loss using a myoelectric prosthesis,” J Neural Eng, vol. 13, no. 1, Dec. 2015.
S. Raspopovic et al., “B I O E N G I N E E R I N G Restoring Natural Sensory Feedback in Real-Time Bidirectional Hand Prostheses.” [Online]. Available: www.ScienceTranslationalMedicine.org
W. D. Memberg et al., “Implanted neuroprosthesis for restoring arm and hand function in people with high level tetraplegia,” 2014, W.B. Saunders.
L. H. Smith, T. A. Kuiken, and L. J. Hargrove, “Real-time simultaneous and proportional myoelectric control using intramuscular EMG,” J Neural Eng, vol. 11, no. 6, Dec. 2014.
A. J. Young, L. H. Smith, E. J. Rouse, and L. J. Hargrove, “A comparison of the real-time controllability of pattern recognition to conventional myoelectric control for discrete and simultaneous movements,” 2014. [Online]. Available: http://www.jneuroengrehab.com/content/11/1/5
M. Ortiz-Catalan, B. Håkansson, and R. Brånemark, “Real-time classification of simultaneous hand and wrist motions using Artificial Neural Networks with variable threshold outputs.” [Online]. Available: https://www.researchgate.net/publication/247778775
S. A. Dalley, H. A. Varol, and M. Goldfarb, “A method for the control of multigrasp myoelectric prosthetic hands,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 20, no. 1, pp. 58–67, Jan. 2012,
M. M. C. Vidovic, H. J. Hwang, S. Amsuss, J. M. Hahne, D. Farina, and K. R. Muller, “Improving the robustness of myoelectric pattern recognition for upper limb prostheses by covariate shift adaptation,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 24, no. 9, pp. 961–970, Sep. 2016,
C. Cipriani, J. L. Segil, J. A. Birdwell, and R. F. Weir, “Dexterous control of a prosthetic hand using fine-wire intramuscular electrodes in targeted extrinsic muscles,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 22, no. 4, pp. 828–836, 2014,
P. F. Pasquina et al., “First-in-man demonstration of a fully implanted myoelectric sensors system to control an advanced electromechanical prosthetic hand,” J Neurosci Methods, vol. 244, pp. 85–93, Apr. 2015.
E. Mastinu, P. Doguet, Y. Botquin, B. Hakansson, and M. Ortiz-Catalan, “Embedded System for Prosthetic Control Using Implanted Neuromuscular Interfaces Accessed Via an Osseointegrated Implant,” IEEE Trans Biomed Circuits Syst, vol. 11, no. 4, pp. 867–877, Aug. 2017.
M. S. Fifer et al., “Simultaneous neural control of simple reaching and grasping with the modular prosthetic limb using intracranial EEG,” IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 22, no. 3, pp. 695–705, 2014,
K. Šosterič, H. Burger, and G. Vidmar, “Adjustment and satisfaction with prosthesis among people after upper limb amputation in Slovenia,” Ortop Traumatol Rehabil, vol. 22, no. 2, pp. 85–93, Apr. 2020.
H. S. Agamy, N. M. Soliman, and F. Fouadmaleka, “Quality of Life among Adults with Prosthesis Limbs Introduction,” 2018.
H. S. Agamy, N. M. Soliman, and F. Fouadmaleka, “Quality of Life among Adults with Prosthesis Limbs Introduction,” 2018.
R. Mousavi, “Creativity for the Common Good: The Case for Fair Use of Prosthetics Patents.” [Online]. Available: https://perma.cc/GNS4-U6KG].
E. Biddiss and T. Chau, “Dielectric elastomers as actuators for upper limb prosthetics: Challenges and opportunities,” May 2008.
S. Bandara, R. A. R. C. Gopura, M. U. Hemapala, K. Kiguchi, D. S. V Bandara, and K. T. M. U. Hemapala, “Upper extremity prosthetics: current status, challenges and future directions,” 2012. [Online]. Available: https://www.researchgate.net/publication/237006427
O. W. Samuel et al., “Intelligent EMG pattern recognition control method for upper-limb multifunctional prostheses: Advances, current challenges, and future prospects,” IEEE Access, vol. 7, pp. 10150–10165, 2019.
