Lower Limb Prosthesis Abandonment and Recycling of Used Components in the Public Healthcare Sector of the Eastern Cape Province of South Africa

BACKGROUND: Waiting times for lower limb prosthesis in the public healthcare sector of South Africa can exceed 12-months. A cause of long waiting times is shortage of prosthetic components. However, sometimes prostheses are abandoned. Recycling components from unused prostheses to mitigate the shortage of components has not been studied. OBJECTIVE: This study aimed to determine the reasons for lower limb prosthesis abandonment and to explore the possibility of recovering unused prostheses for component recycling in the public healthcare sector of the Eastern Cape Province, South Africa. METHODOLOGY: A cross-sectional survey was conducted among individuals who had stopped using or had an unused lower limb prosthesis. Participants were recruited using total population sampling from three public hospitals with Orthotics and Prosthetics centres in the Eastern Cape. During routine follow-up (July–August 2025), 92 individuals who had received a lower limb prosthesis between January 2021 and January 2025, or their next of kin where applicable, were contacted. Individuals still using their prosthesis and children (<18 years) were excluded. The remaining 45 non-users or next of kin were invited to participate. A self-developed structured questionnaire was administered via short (10–15 minute) interviews, and data were analyzed descriptively using SPSS (version 31). FINDINGS: A total of 43 participants aged 18–77 years (median 54; interquartile range 24), including 54% (n=23) male participants, consented to participate and completed the interviews. Twenty-two participants (51%) reported poorly fitting sockets as the reason for non-use. Forty-two (98%) participants were in favour of recycling components. Forty (93%) of the unused prostheses were modular. The majority were transtibial (81%), followed by transfemoral (12%) and knee disarticulation (7%). The main barrier to recycling identified was damaged components (19%). Thirty-nine (91%) prostheses were recovered from which 190 components can possibly be recycled. CONCLUSION: The findings extend existing knowledge on prosthesis abandonment and highlight an opportunity to implement component recycling practices to improve access, reduce waiting times, and lower costs in low-resource settings with high prosthetic service demand. The study may have important implications for prosthetic service delivery and policy in the Eastern Cape and South Africa. Layman's Abstract In South Africa’s public healthcare system, people with a lower limb amputation may wait more than a year to receive an artificial limb (prosthesis). One major reason is a shortage of prosthetic parts. This study explored why some people stop using their prostheses and whether parts from these prostheses could be collected and reused. Participants were recruited from three hospitals in the Eastern Cape that provide orthotics and prosthetics (O&P) services. As part of routine follow-up, between 28 July and 22 August 2025, clinic staff contacted 92 people who had previously received a lower limb prosthesis, or a family member if the person was unavailable. Forty-five people could take part in the study because they were no longer using their prosthesis. Of these, 43 agreed to participate. Each person took part in a short interview lasting about 10–15 minutes, and their answers were summarized. Participants were between 18 and 77 years old. Twenty-two people stopped using their prosthesis because it did not fit properly. Forty-two participants supported the idea of reusing parts from prostheses. The most common reason that prevented reuse was damage to parts (19%). In total, 39 prostheses were collected, and from these, about 190 parts could potentially be reused. These findings suggest that recycling of prosthetic components is acceptable to users. Recycling offers a practical solution to component shortages in resource-limited healthcare settings and may support better prosthetic care in South Africa. Policymakers and clinicians together with prosthetic users should develop ways to include recycling into routine prosthetic practice. Further research is needed to develop guidelines that take cultural beliefs into account and ensure that reused prosthetic parts are safe and of good quality. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/47107/34964 How To Cite: Goxo X.L, Visagie S, Ned L. Lower limb prosthesis abandonment and recycling of used components in the public healthcare sector of the Eastern Cape Province of South Africa. Can Prosthet Orthot J. 2026; 9(1): 7. https://doi.org/10.33137/cpoj.v9i1.47107 Corresponding Author: Xolani Lennox Goxo, Affiliation: Division of Disability and Rehabilitation Studies, Faculty of Medicine and Health Sciences, Stellenbosch, University, Cape Town, South Africa. E-Mails: 20225393@sun.ac.za; XolaniG@dut.ac.za ORCID ID: https://orcid.org/0009-0000-4408-1381