Forbes: Why Russia is increasing the import of prostheses from Germany

In the first half of 2026, Germany sold Russia prosthetic limbs and joints for €79 million — about 7.4 billion rubles. This is almost a third more than a year earlier. Deliveries of endoprostheses for the year increased by one and a half times, to €37.8 million. The figures were calculated by Forbes, based on Eurostat data, and Welt am Sonntag previously wrote about the growth of German supplies. Market participants attribute the boom to three reasons: the state began to issue prostheses faster, users are younger and require more complex products, and more quotas are allocated for joint replacement operations. Russian manufacturers simply do not keep up with the jump in demand.

In January-June 2026, Russia imported prosthetics and artificial joints from Germany by almost €19 million more than in the same period last year. The “articular” category rose the fastest: endoprostheses of the hip, knee and other joints, which are put surgically, gave almost 70% of the total increase. Hand and leg prosthetics with components accounted for €41.2 million - plus 16% by the first half of 2025.

If you wind down by 2021, the scale will become clearer: the supply of prosthetic limbs from Germany increased 5.4 times (from €7.6 million), endoprostheses – 6.1 times (from €6.2 million). The fracture occurred in 2024: prosthetic limbs, held in 2022-2023 at the level of about €25 million per year, for the year jumped almost twice to €48 million, and in 2025 added another 76% to €84.4 million. Endoprostheses grew along the same trajectory: €22.8 million and €25.2 million in 2022-2023, €44.7 million in 2024 (×1.8) and €60.5 million in 2025 (+35%).

According to the Ministry of Labor in the EMISS system, in 2024, the state issued 152,661 prosthetic arms and legs to people with disabilities against 99,515 a year earlier - more than in any of the previous ten years. Nine out of ten products are prosthetic legs: 138,118 vs. 91,220 in 2023. Prosthetic hands were issued 14,543 against 8295. Data for 2025, the Agency has not published.

In 2025, 75.4 billion rubles were initially laid for all technical means of rehabilitation, including prosthetics, and 120 billion rubles were spent on the Social Fund. In the federal budget for 2026, 98.16 billion rubles are planned for these purposes - separately, the cost of prosthetics is not allocated.

Ivan Khudyakov, the general director of the manufacturer of prosthetics Steplife, associates the growth of the market with social policy: prosthetics under an individual rehabilitation program are paid by the Social Fund, and they are issued much faster. Previously, the receipt of a prosthesis could be delayed up to a year: first it was necessary to issue a disability, then wait for the fund to purchase the product under a state contract. Now disability after amputation is issued in a few days, and the prosthesis can be bought with an electronic certificate, without waiting for purchase and re-examination for disability. Therefore, now the selection of the prosthesis and preparation for prosthetics begin immediately after the amputation, he explained.

The portrait of the buyer also changes. “The age category of users of prosthetic limbs has declined significantly. And young and active people make increased demands on the functionality and manufacturability of products, says Nikolai Ermalyuk, founder of Metiz Group, which makes components for prosthetic arms and legs. According to Rostec, until 2022, young people accounted for about 8% of those in need of prostheses, and by 2025 the share reached 15-20% - mainly participants of the "special operation"* who were injured.

The Russian manufacturers of components for prosthetic legs, according to Yermalyuk, “historically developed somewhat slower” and could not immediately close the demand for high-tech products. “This created objective prerequisites for increasing the share of international brands, including German ones,” he added.

Hands with chips

The most expensive products are prostheses with microprocessor control: the knee joint, foot or hand are equipped with sensors and electronics and adapt to human movements, unlike conventional mechanical ones. The growth of demand for such models in March 2025 was noted by the head of the Ministry of Labor Anton Kotyakov: their purchases more than doubled, which is why the average cost of prosthetics for one person at the expense of the state reached 970 000 rubles.

Director of the Association "AURA-Tech" Ivan Biryukov explains the rise in prices of German procurement: "According to our estimates, one of the main reasons is the increase in demand for high-tech components for prosthetics of the upper and lower extremities." Replace them with domestic analogues is the most difficult: “combines complex mechanics, electronics and control algorithms.”.

The main beneficiary is Ottobock from Duderstadt, who calls himself the world leader in bionic prosthetics. In the first half of 2026, the company's revenue grew by more than 6%, to €854.1 million. The head of Ottobock Oliver Jacobi confirmed the growth of demand from Russia, but called this direction a small part of the European business and insists that the company supplies in Russia only civilian. Experts polled by Forbes are confident that Germany’s share of supplies will continue to grow.

“At the moment, it is impossible to replace Ottobock’s products with imports, there are a number of popular components, which have no analogues in Russian production yet,” says Grigory Lein from the prosthetic and orthopedic center Skoliodzhik.ru, working on German components.

The gap is clearly visible in the numbers. Simple parts - fasteners, tubes, adapters, non-electronic feet - in Russia have long done themselves, says Khudyakov. Therefore, in pieces, domestic products occupy about 80% of the market, but in money - only 30%: the gap is created by expensive high-tech nodes, where the share of imports, according to Steplife for the spring of 2025, reaches 70%. The weakest position with bionic knees and feet: “Russian bionic feet are simply not on the market, only we have now brought the first pilot product,” says Khudyakov. Comparable with Ottobock quality, “and then not all positions”, there are a few companies – Lein singles out “Metiz”. In prosthetic arms, the picture is reversed: according to Kama Flow, about 45% of this market is held by the Russian Motorika. In total, about 20 Russian companies produce functional nodes, and their production for 2025 increased by 16% in money and exceeded 6 billion rubles, Deputy Minister of Industry and Trade Ekaterina Priezheva reported.

With endoprostheses, the mechanics are different: since 2015, they are installed in hospitals as part of high-tech medical care (HMP), and the clinics themselves are purchased, receiving a state quota for each operation. The analytical company Eqiva collected open data on quotas for endoprosthetics: in 2025, clinics conducted at least 86,216 joint replacement operations for 22.6 billion rubles. The sample included 255 clinics from 63 regions - the data are not published in full, and operations at the expense of patients do not take this figure into account at all.

The volume of VMP-endoprosthetics is growing every year: in comparable clinics in 2025, operations became 37.8% more than in 2024, and 48.3% more than in 2023. Robotic operations are developing fastest: in 2023 there were about 900 for the whole country, by 2025 - almost 3000. The leading federal centers are the Novosibirsk Research Institute of Traumatology and Orthopedics named after Tsivyan (570 interventions for 2025), the Priorov National Research Center (524) and the Petrovsky Russian Scientific Center for Surgery (430).

Traumatologist-orthopedist of the RNCH Oleg Koval connects the growth with the fact that people live longer and remain active longer: endoprosthesis of large joints “is gaining momentum from year to year.” Dmitry Smirnov, a surgeon at the Denova Clinic in Vladivostok, added: “The population is aging, and we see a steady increase in hip fractures amid severe osteoporosis.” “The more requests, the more finances are allocated,” Koval says.

Arthrologist "SM-Clinic" Victor Gudkov reminds: in the hinterland still meet people with deformed joints and impaired gait, years have not received the necessary help. Now, according to him, availability has increased: there are more orthopedic traumatologists, IDPs are provided in more regions, and patients from small towns are more often sent to regional hospitals and federal centers.

In Russian clinics, endoprostheses of large American and European manufacturers are traditionally put. But they are becoming more expensive, and some clinics introduce Chinese and Indian analogues into circulation. “The cost of quality imported endoprostheses has increased in recent years. Therefore, medical organizations have to look for more affordable options that can be used within the existing tariffs and quotas, explains Gudkov.

Chinese endoprostheses are put in the RNCH, but only certified and proven: “Doctors go to factories, look, study, and then, after a thorough study of the technique, tool, data of literary reviews and trial installations of the endoprosthesis, the decision on centralized procurement is already made,” says Koval. In the clinic of Academician Roitberg, where more than 800 endoprosthetics of large joints are performed annually, they work with products from India, Switzerland, Germany, the UK and the USA, said the head of the trauma department Evgeny Tarasov.

The domestic share in the market of endoprostheses is still modest: in 2024, BSS pharmaceutical holding launched the EndoArt plant in St. Petersburg with a capacity of 35,000 sets of hip endoprostheses per year. Its general director, Julia Gukkina, then estimated import substitution in hip endoprostheses at 5%, and in knee ones at 0%.

In total, from the EU countries for the first half of 2026, Russia received prosthetic limbs and endoprostheses for €144.9 million against €66.5 million for the same period in 2021. Statistics cover 11 countries, but 94% account for the three: 55% – Germany, 23% – the Netherlands, 17% – Belgium. In the endoprostheses, the advantage is even more noticeable: Germany accounted for 92% of the increase in supplies from the EU, and its share increased from 16 to 52%.

The reason is the lack of complex components, Khudyakov believes. Quickly replace German components will not work, experts agree.