Andrei Danko, a 49-year-old paratrooper from the Ulyanovsk region, fought in Ukraine with the 83rd Separate Guards Air Assault Brigade near Bakhmut. He was seriously wounded in late 2024 and lost his leg. After being discharged from a hospital for drinking alcohol — something he does not deny — he was not formally granted disability status, leaving him without access to proper rehabilitation and benefits.
For more than a year, Danko has been trying to obtain a prosthetic limb, but says he has been repeatedly redirected between different agencies, unable to secure the paperwork required. In a video appeal addressed directly to President Vladimir Putin, he described his situation in blunt, emotional terms.
“I can’t even go outside to buy bread in this wheelchair. At least give me a stick — tie something to my leg,” Danko said. “I know what they’ll say: It’s my own fault. Yes, it’s my fault for believing,” he concluded.
Danko is not an anomaly. As the war grinds on, the number of disabled veterans in Russia continues to grow. In 2023, the case of 53-year-old Vadim Sharipov from Yakutia drew national attention. He lost his arm in the war in Ukraine and waited nearly a year for a prosthesis. What he eventually received was a metal rod strapped to his shoulder. A more functional device was provided only after media coverage brought attention to his case.
While Russian officials have presented the rise of the prosthetics sector as a point of national pride, the industry’s growth is part of a system struggling to meet the needs it has helped create.
When Russia launched its full-scale invasion of Ukraine — which entered its fourth year in February — it was structurally unprepared on many levels. Prosthetics is one of the clearest examples. Before 2022, the system was designed for a relatively stable and limited demand. The war abruptly produced a mass population of amputees, and the state’s response has been to scale up production within an institutional and technological framework never built for this kind of pressure. Russia publicly frames itself as resisting the West, yet it remains dependent on Western components and technology for functional prostheses. Much of its manufacturing capacity still rests on Soviet-era plants: It is far easier to produce large quantities of simple, outdated, generic devices than to deliver medically adequate, customized ones. Volume becomes the metric of success, even when it undermines rehabilitation outcomes. Large state-affiliated corporations like Rostec, trying to consolidate the sector under the banner of technological sovereignty, have in practice reinforced centralization and procurement rules that prioritize scale and political loyalty over patient needs.
The result is an industry that is visibly expanding — financially and statistically — while the system meant to serve amputees becomes more strained, less flexible and increasingly unequal.
The scale of the transformation is not difficult to measure. Tehnologii Doveriya (“Technologies of Trust”), the Russian successor brand to PricewaterhouseCoopers’ former local arm, published a study of the country’s assistive technologies market in late 2025. During the course of the war, the market for upper-limb prosthetics grew more than fourfold, from 2.7 billion rubles in 2021 (about $37 million at the time) to 12 billion rubles (about $120 million) in 2025. Growth in lower-limb prosthetics has been slower but still striking: from 14.5 billion rubles to 41.3 billion rubles over the same period. By 2030, the firm projects, the upper-limb market will reach 26.3 billion rubles and lower-limb prosthetics 92.1 billion.
Part of what is driving those numbers is the nature of modern warfare. Before the war, 60% to 70% of amputations in Russia were linked to vascular disease. Now, more than half of the demand is driven by trauma, primarily combat injuries in Ukraine. “This is true on both sides,” said Alexander Lerner, an Israeli orthopedic trauma surgeon who has treated large numbers of battlefield injuries and consulted both Ukrainian and Russian doctors. “Drones hover over the battlefield and target evacuation teams. By the time wounded soldiers reach a hospital, they may have spent hours with tourniquets applied to their limbs. Very often, arms and legs have to be amputated as a result.” In 2021, Russia required 111,700 lower-limb prosthetics and 10,800 upper-limb prosthetics. By 2025, those figures had climbed to 159,800 and 19,600. Estimates from Rostec are even higher: Russia now has around 500,000 amputees, and the state must provide approximately 200,000 prosthetic limbs each year.
The distortions ripple beyond Russia’s borders. Lower-limb prosthetics now account for 27% of Russia’s assistive technologies market, compared with a global average of about 5%. Upper-limb prosthetics make up 8%, versus a global average of roughly 2%. Two major private manufacturers, Steplife, founded in 2019 as a small startup producing knee modules, and Motorika, often described by market analysts as the industry’s flagship, are both planning initial public offerings in 2026. By the end of 2025, Steplife had become the fastest-growing company in Russia’s medical technology sector, according to the business daily Kommersant. Both Steplife and Motorika declined to comment, saying they did not wish to speak to an American publication. After four years of war, many Russian executives consider contact with foreign media risky. Some agreed to speak only on condition of anonymity.
In late 2025, Deputy Defense Minister Anna Tsivileva, the daughter of a cousin of Putin, stated that Russia had reached a “flagship level” in prosthetics thanks to the invasion. “It is no secret,” she said, “that 11.5 million disabled people who lived in our country before the special military operation did not have access to the rehabilitation they needed.” Tsivileva also chairs the state-backed Defenders of the Fatherland Foundation, one of the organizations responsible for providing prosthetics to wounded veterans. The statement managed to be simultaneously a boast and an admission: that the war, for all its human cost, had finally forced the state to attend to a population it had long neglected.
One of those is Elena Volokhova, who lost an arm and a leg 14 years ago and only received a mechanical arm less than a year ago. “There is an absolute shortage of funds. This is discussed at every meeting,” said Volokhova, who heads the nongovernmental organization Opora, which advocates for people with mobility impairments. “In 2025, in many regions, allocated funds were exhausted in the first half of the year, and additional financing had to be requested.”
The foreign companies that had long supplied Russia’s prosthetics market did not wait to see how the invasion would play out. The Icelandic company Ossur halted deliveries after February 2022. The German manufacturer Ottobock began delaying shipments for months. These moves were part of a broader exodus of European companies from the Russian market following the invasion of Ukraine, driven by sanctions, export restrictions and the growing legal and reputational risks of doing business in Russia. As demand surged, the number of prosthetics available on the market initially fell sharply. In 2022, only 24% of the need for upper-limb prosthetics was met; for lower limbs, the figure was 26%.
The vacuum drew in new entrants. “To catch up with Ossur and Ottobock would take decades. In the era of globalization, there was no point competing with them,” said Anna Shatkova, a representative of the medical company Madin in Nizhny Novgorod in the central Volga region. “But in 2022, we began developing a lower-limb prosthesis equipped with a microprocessor-controlled knee module. In the four years since, several companies have introduced their own domestic knee units.” Madin, which previously produced rehabilitation equipment such as treadmills and exoskeletons, plans to enter the prosthetics market this year, positioning itself in the same price range as the foreign manufacturers it is hoping to replace.
Prosthetic workshops that assemble custom limbs have multiplied as well. “Three years ago, there were about 250 such companies across the country. Now there are roughly 500,” said Grigory Lein, chief executive of Skoliologik, a company that produces rehabilitation equipment and prosthetics. “There was a real surge two years ago. Growth has slowed since then, but the sector as a whole has expanded two to three times in just a few years.” Revenue has grown even faster than production volumes, partly because more patients are receiving advanced and expensive devices, including externally powered, or bionic, prosthetics. In 2024, about 19% of amputees received bionic upper-limb prosthetics, 28% received active mechanical devices and 53% were fitted with cosmetic prostheses.
Russia now produces a range of competitive prosthetic components that clinicians choose on genuine medical grounds, not merely out of necessity. “We base our decisions on medical criteria,” Lein explained. “If a patient requires high adaptability rather than high load tolerance — for example, walking on gravel or sand — we may choose a Russian supplier. Delivery times for domestic feet are shorter than for German or Icelandic ones. Many Russian components are better than Indian or Chinese products, though still behind German and New Zealand manufacturers.” Certain high-end features remain out of reach: Fully waterproof upper-limb prosthetics are not yet produced in Russia, nor are prosthetic hands with vibrotactile feedback.
Nor has the country fully broken its dependence on foreign supply chains. Following Russia’s invasion of Ukraine, Western countries imposed sweeping sanctions, including export controls and financial restrictions, that disrupted trade and made it harder to import medical equipment and components. While prosthetics themselves were not always directly sanctioned, supply chains were affected by restrictions on technology, banking and logistics, as well as by the voluntary withdrawal of many foreign companies.
In late 2025, Svetlana Orlova, an auditor at the Russian Accounts Chamber, stated that 55% of prosthetics were still being purchased from countries “that are at war with us.” Sanctions reshaped supply routes but did not sever them. Instead, parallel import channels expanded, and domestic firms accelerated their own development. The result is a hybrid system, part import-dependent, part improvised industrial policy, held together by workarounds rather than genuine self-sufficiency.
That strain shows up in the workforce, too. The rapid growth of the sector has created an acute labor shortage. Entry-level prosthetic technicians can command salaries of roughly $2,600, more than many IT specialists earn and about twice the national average wage. “The market is overheated,” Lein said. “Technicians are being paid 400,000 to 500,000 rubles. Some make as much as a million. And at that level, even people with limited qualifications can find work.” According to Tehnologii Doveriya, there were about 700 certified prosthetists in Russia in 2023, nearly three times fewer per capita than in the United States, against an estimated need of around 3,000. Prosthetic technicians are trained at only three educational institutions in Russia, training roughly 100 specialists per year. They are taught to take measurements and make casts of residual limbs, fabricate and assemble prosthetic devices, and adjust them to ensure proper fit and alignment — work that combines clinical knowledge with hands-on technical skill.
The expansion of the industry has not translated into adequate care for those who need it most. In 2025, only 72 % of demand for upper-limb prosthetics was met in volume terms; for lower-limb prosthetics, the figure was only 54%. Federal spending on technical rehabilitation equipment has risen, from 37 billion rubles in 2022 to 75.4 billion in 2025, with 98 billion allocated for 2026 — yet it consistently falls short.
Since 2023, Russia has operated an electronic certificate system intended to allow disabled individuals to select a prosthesis from any approved supplier. The reform has increased formal access — previously, patients wanting a specific device had to buy it themselves and seek reimbursement, a transaction beyond the reach of most. But the system introduced new fragilities. When it malfunctions, patients can no longer buy devices independently. In the Krasnodar region last year, amputees went nearly six months without receiving prosthetics. Unused electronic certificates simply expire.
Even when the system functions, quantity is not quality. A survey compiled by Opora in January 2026 found that more than 50% of amputees were dissatisfied with what they had received. The St. Petersburg branch of the Defenders of the Fatherland Foundation found similar figures among veterans in March 2025: 40% of amputees who received lower-limb prosthetics through the Social Fund were dissatisfied — a figure that held across both the foundation’s own clients and those supplied through the Defence Ministry. Upper-limb prosthetics were not fully mastered by any of the recipients surveyed, with complaints including uncomfortable sockets, heavy devices and frequent mechanical failures. “They produce faulty devices just to get paid. The certificate is spent, and the prosthesis ends up in a corner because it’s unusable,” Volokhova said. “We spent two years pushing the labor ministry to introduce standards. They take effect in 2026. I don’t expect anyone to be punished. But at least some of these companies will leave the market.”
Anna Kilina, a stand-up comedian and disability activist who was born without a hand, has publicly criticized Motorika for years, publishing video reviews arguing that its upper-limb prosthetics are unreliable and prone to breaking. “For experienced users, Motorika is a red flag,” she said. “A friend of mine filed a complaint with the prosecutor’s office over the quality of her prosthesis. The company gaslit her and refused to carry out repairs.” Those willing to contest the system are more likely to receive appropriate devices — but they are a minority. “Most amputees don’t know how to fight for their rights. Only about 10% reach the prosecutor’s office,” Volokhova said. “When we or other advocacy groups get involved, the chances of success increase significantly.”
The problem of poor access and the problem of poor quality are related but distinct, and they fall unequally. For those who know how to navigate the system — who understand what they are entitled to, and are prepared to spend months visiting offices and filing appeals — better outcomes are possible. For everyone else, the system delivers whatever it can.
Alexander is a Paralympian from the Urals in Russia who lost part of his leg 20 years ago in a robbery. (He asked that his last name be withheld for security reasons.) For most of that time, he received devices made from imported components. The prosthesis he was given at the end of 2025 was of noticeably lower quality. “They made a socket I can’t walk on. The silicone liner is bad, too — thin like a sock. My stump hurts in it.” In the end, he assembled one functional prosthesis from two separate ones. His sports prosthesis became a separate bureaucratic struggle: His rehabilitation plan, he later learned, listed only the cheapest available model. “Recently they’ve been allocating less money for prosthetics,” he said. “If you really want something better and are prepared to go through repeated medical evaluations and appeals, you can eventually get it. But you have to visit office after office.”
For veterans of the current war, the failures are harder to excuse. Maxim Marushchuk, 28, explained that he lost his right arm below the elbow in combat and has been left without a prosthesis, without work and with a pension of less than $50 a month. In February 2026, he published a video on VKontakte, Russia’s answer to Facebook, stating that for seven months he had been unable to formalize his status after the local military office lost his personal file. Without official recognition of his injury, he cannot receive compensation or begin prosthetic treatment. He tried to find work as a supermarket security guard, monitoring surveillance cameras. He was rejected. “They told me to get a prosthesis first and then come back — not to scare people,” he said.
In September 2025, a video circulated online from a military hospital showing a wounded soldier who had fashioned a makeshift artificial leg out of plastic bottles. Other patients, speaking off camera, said that many had been waiting months for proper prosthetics. “On the legislative level, the state has provided social guarantees,” military lawyer Tatyana Zavyalova told New Lines. “But at the local level, officials engage in what I would call a ping-pong game, shifting responsibility and violating the rights of participants in the special military operation. The reasons are lack of funding and, I would assume, poor planning.”
A legal advocate specializing in military cases told Sibir.Realii (Siberia.Realities), a regional news project of Radio Free Europe/Radio Liberty, that he had documented more than 100 complaints alleging that paperwork errors are used to delay formal recognition of disability status. “This is not a new problem. It has existed since 2022,” the lawyer said. “Military hospitals create errors in documentation. Units reassign soldiers retroactively to different formations. Everything is done to delay official recognition of disability.” The advocate added that some soldiers were not even being sent home: “Now even soldiers who have lost both legs struggle to leave their units. Some are kept at their assigned bases, others in combat zones. They are not released into civilian life.”
Earlier this year, a video appeared online in which three men identifying themselves as amputees from the 71st Motorized Rifle Division say they are being prepared for redeployment to a combat zone. Mikhail Mukmenov, 44, shows the stump of his right foot to the camera. Sergei Bogdanov, whose lower right leg has been amputated, appears on crutches. “They are sending me to the front line even though I cannot move independently or hold a weapon,” he says. A third man, Andrei Startsev, 39, displays an empty pant leg. He says his leg was amputated in 2024 and that he is still awaiting a prosthesis. He claims he is being sent back into combat instead of rehabilitation. The video was shared in social media groups used by relatives of servicemembers, then removed. The identities of the men were partially verified by the anti-war monitoring project Ne Zhdi Khoroshikh Novostei (Don’t Wait for Good News), which archived the footage before it disappeared.
If their claims are accurate, they describe a system that has not merely failed to provide prosthetics but has ceased to regard their absence as a reason to keep a soldier from the front. The industry, meanwhile, continues to grow.
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