Portuguese Ingenuity Gets Amputees on Their Feet Fast
- @ Cynthia Adina Kirkwood
- Aug 20
- 9 min read
Updated: Aug 21
The Embassy of the State of Palestine in Portugal expressed gratitude for the humanitarian and medical support of Dima, 16, and Malak, 7. (Photo from the Embassy of the State of Palestine in Portugal)
Two Palestinian girls, who each lost a leg in the bombings of the Gaza Strip, arrived, at Francisco Sá Carneiro Airport, in Porto, in wheelchairs on August 17. However, in six months, they plan to leave the airport on their own two feet and fly to safe haven in Egypt.
Malak, 7, and Dima, 16, will receive prostheses and undergo physiotherapy and rehabilitation, reported SIC Notícias (August 18). A prosthesis is an artificial device which augments or replaces a missing part of the body. It can restore function and alleviate pain.
The cost of the treatments will be covered fully by the two hospitals: Dima at the Hospital da Prelada, in Porto, run by the Misercórdia do Porto, and Malak, at the Center of Rehabilitation Medicine of Alcoitão, in Alcabideche, Cascais Municipality, run by the Misercórdia de Lisboa. The organizations, Heal Palestine, Parents for Peace and the Palestinian Refugee Support Group, will provide food, transportation and accommodation.
This is the first time that Portuguese non-profit groups have brought children to Portugal for medical treatment from Gaza, where UNICEF says that one child has been killed each day since a ceasefire began in October 2025.
There are nearly 150,000 Palestinian children in need of medical care, reported SIC Notícias. Omar, 13, is another one of them. He lost a leg in an Israeli airstrike which killed several of his cousins. One year later, he is still waiting for a prosthesis and living in a displaced persons camp west of Gaza.
Amparo's Solution: Fast and Portable
It is the amputees, like Omar, who Federico Carpinteiro, CEO of Amparo Prosthetics and formerly CEO of his own company, Adapttech, hopes to help as well as those outside of war zones. Amparo, an international medical device firm, acquired Adapttech in 2025. More than 600 Amparo prostheses already have been attached to patients in war zones, such as Ukraine and Gaza, reported Expresso (July 23).
In fact, this is "the only prosthetic technology currently being used in Gaza", said biomedical engineer Federico Carpinteiro, who was one of five Portuguese on the Forbes European 30 Under 30 list in 2021.
Why is Amparo technology the only one being used in Gaza? Because it is fast, and it is portable.
A prosthetic leg includes several parts: the socket; the suspension system, which attaches it to the body; the structural tube, adapters, and it also may include the ankle and foot.
However, it is the socket, "the only part of the prosthesis which is custom-made for each individual", which is key, because it will receive the amputated limb. The socket will be "responsible for the user's comfort but also for the user's ability to control it".
Amparo can deliver a prosthesis in less than two hours as compared to weeks.
Amparo supported Ali, a former athlete and professional cyclist from Gaza, during his second prosthetic fitting, according to the company. Ali lost his right leg in the war. For him, prosthetic care is not only about standing and walking again. It is about rebuilding confidence, restoring movement and regaining activities which give his life meaning, including cycling. Together with Save the Children International, Save the Children Egypt, Save the Children Global Ventures and OrthoMedics Egypt, the clinical team was able to create and fit an Amparo socket within the same day.
Amparo molds the socket, made of proprietary thermoplastic, textile and Kevlar, directly onto the remainder of a person's limb without intermediate steps. The more common process requires taking a mold of the residual limb, filling the mold with plaster and making temporary fittings.
"It's a trial-and-error process, which can require between four and seven visits, "can take 40 hours of this work, and takes weeks to complete (the prosthesis)", not to mention the body changes which can occur over this span of time, explained the CEO.
In addition, the Amparo prosthesis can be re-moldable up to five times, meaning that "if the person experiences any changes because they gained muscle, gained weight or lost weight, they can return to the clinic, the socket can be reheated, adapted again, and a new one won't be needed."
However, if going to a clinic is an impossibility, Amparo's solution is portable.
"We can operate within a normal clinic, but we also have our portable kit, which fits entirely inside a wheeled suitcase. As long as there is electricity, it allows us to make a prosthesis anywhere in the world".
Expresso interviewed Federico Carpinteiro for its League of Innovators podcast.
Research and Development
Federico Carpinteiro specialized in biomedical engineering at the Faculty of Engineering, the University of Porto, reported Forbes Portugal (June 10, 2021).
He, along with his colleagues, was shocked by the global need for prostheses, reported Expresso.
More than 65 million people worldwide are living with limb amputations, but only 20 percent have a prosthesis, according to AT Scale, Global Partnership for Assistive Technology, hosted by the United Nations Office for Project Services (UNOPS).
Founded around 2014, Adapttech was a graduate startup from the University of Porto's Science and Technology Park and had received 7.3 million euros in investment rounds over the past nine years, reported Notícias, Faculdade de Engenheira, Universidade do Porto (News, Faculty of Engineering, University of Porto) (March 6, 2025). Eventually, it was headquartered in Birmingham, England, although its research and development center remained in Porto.
Federico Carpinteiro and Mario Saenz Espinoza, who both received doctorates from the University of Porto, were business partners at Adapttech, which was the first company worldwide to combine 3D laser scanning with dynamic pressure measurements between the socket and the residual limb to optimize lower-limb prosthetic fit, according to the University of Porto.
"Adapttech's INSIGHT is a tool used by prosthetists which creates a 3D model of the inside of the prosthetic socket, representing in real time the pressures being felt between the socket and the limb. This allows us to see how the adaptation between the amputated limb and the prosthetic socket is going. We can understand if things are wrong, even if the amputee isn't feeling them initially, and correct them before the problem occurs," explained
Federico Carpinteiro, according to Forbes.
Diabetics Have Greatest Need
At the University of Porto, Mário Espinoza had been working on developing insoles for diabetic feet.
Globally, lower limb amputations are commonly performed for complications of diabetes, peripheral arterial disease (diabetics are more likely to have a narrowing of the arteries in the legs and arms), and trauma (falls, car accidents and war), according to Global Temporal Trends in the Incidence of Major Lower Limb Amputations, European Journal of Vascular and Endovascular Surgery (August 2026).
Eighty percent of lower-limb amputations in the United States is a result of diabetes complications, and the numbers are increasing, according to Preventing Diabetes-Related Amputations (May 15, 2024), U.S. Centers for Disease Control and Prevention.
A cut in a diabetic's foot is serious. Diabetes complications can include nerve damage and poor blood flow, according to Mayo Clinic. Nerve damage can prevent a diabetic from feeling skin sores, or ulcers. Less blood flow can make it harder for sores to heal, so sores worsen quickly.
Any injury to a diabetic's feet needs immediate care. One which will not heal harms tissue and bone and may lead to amputation of a toe, a foot or part of a leg.
A common problem with lower limb prostheses is a poor socket fit causing pain and sweat, which leads to the skin opening, turning red or raw, and hurting, according to Issues faces by people with amputation(s) during lower limb prosthetic rehabilitation: A thematic analysis (November 16, 2021), Prosthetics and Orthotics International.
My Grandfather
Pain and frustration can lead to people not using the prosthesis.
And then, there are also people who never get to the point of even considering an artificial limb. My diabetic father's father was such a person. In 1961, deadly Hurricane Hattie hit Belize, then British Honduras, trapping my grandfather under his wooden house, built on stilts. While struggling to keep his head above water, the current carried a piece of fast-moving glass, which cut his foot.
My mother flew to Belize from New York to accompany him to The Mount Sinai Hospital in Manhattan, New York, where the doctors told him that he needed to have a leg amputation. He refused to have his leg cut off, seemed to rally briefly and then died a few days later.
"Adjusting to an amputation is like adjusting to loss of a family member. You go through a grieving process, so psychological counseling is available, if needed," said Dr. Karen L. Andrews, a physical medicine and rehabilitation specialist at the prestigious Mayo Clinic in Rochester, Minnesota, in an interview on Mayo Clinic Radio (May 5, 2018).
Building Business Acumen
After the founding of Adapttech, the biomedical engineers acknowledged their need to sharpen their business skills. Following a program at COTEC Portugal, a business association for the promotion of innovation and technological cooperation, and Porto Business School, they were accepted into an accelerated program at Carnegie Mellon University in Pittsburgh, Pennsylvania, reported Forbes.
They traveled more than 5,000 kilometers (3,107 miles) in seven states in a rented car.
"We would Google 'prosthetic centers' and go door-to-door asking to speak with the director of these companies," Carpinteiro told Forbes. They returned to Portugal with three letters of intent, "saying that if we developed the system we were proposing, they would come and work with us".
The first tests of Adapttech's prostheses were carried out at the Center of Rehabilitation Medicine of Alcoitão, in Alcabideche, Cascais Municipality, now a 60 year-old institution. The experience "allowed us to greatly improve the system and have this very close contact with patients, to see people's reactions, to see different patients and learn their stories, to understand how difficult it was to resume their normal lives", explained Federico.
He recalled "an English gentleman living in Portugal who, for the past 11 years, had been trying unsuccessfully to find a prosthesis that would fit him well. He contacted us and, for six weeks, we worked to make him a prosthesis. In the end, there was success, and the gentleman cried, clinging to the prosthesis technician".
Shifting to Maia
Adapttech achieved engineering, but not commercial, success, Federico Carpinteiro told Expresso:
"We were a company very focused on research and development. We had been very successful from an engineering and design point of view. We had numerous awards, immense recognition but, commercially, we had never managed to succeed."
Amparo, which acquired the company in February 2025, offered a global network. It is present in more than 40 countries, and it already has reached more than 6,000 users. Besides being the CEO, Carpinteiro is also a shareholder.
The financial terms and purchase price of Amparo's acquisition of Adapttech were not publicly disclosed, reported Eco (February 27, 2025).
With a team of about 25, Amparo recently moved to Maia Municipality, in the Porto Metropolitan Area, where they plan to have the company's main production center, shifting part of its production of fittings from the United States there.
World's First Bionic Sonic
After traveling the world, in 2014, to talk with amputees and their technicians and noting the importance of the socket, Amparo was founded as a German company in 2016, according to its website. Amparo started manufacturing and commercializing the Amparo Confidence Socket, developing the market in Germany and neighboring countries. In 2019, it began engaging with customers from five continents. In 2021, its European headquarters moved to the United Kingdom, but it kept its warehouse and logistics platform in Germany. In the same year, it founded Amparo Prosthetics Inc. in the United States.
The company's future goals are ambitious, reported Expresso. CEO Carpinteiro said that there is the objective of transforming the socket into intelligent technology so as to act preventively.
"The prosthesis itself alerts the clinician, who monitors the person when there is a change in activity, when there is a change in fitting. Needs and problems can be anticipated."
The second goal is even more ambitious, "to create the world's first bionic socket which, in real time, is constantly adjusting its shape and rigidity." It would be a device which reacts automatically to the user.
History of Artificial Limbs
Artificial limbs of some type, such as a forked stick, have been used since the beginning of humankind, according to History of Amputation Surgery and Prosthetics, Digital Resource Foundation for the Orthotics & Prosthetics Community. War seems to have been the stimulus for the improvement of amputation surgical techniques as well as the development of improved prostheses.
Soldiers who lost their limbs in battle often used artificial ones made of wood or iron, according to Prosthetics Through the Ages (May 11, 2023), NIH MedlinePlus Magazine, National Library of Medicine.
For example, 2,200 years ago, the Roman general Marcus Sergius Silus lost his right hand during the Second Punic War. He replaced it with an iron one, which was designed to hold his shield. Knights of the Middle Ages sometimes used wooden limbs for battle or to ride a horse. In the 16th century, the French surgeon Ambroise Paré designed some of the first functional prostheses for soldiers leaving the battlefield.
While prostheses still were made of combinations of wood, metal, glue and leather, even up to the 20th century, they were becoming more functional. From the late 15th century to the 19th century, France and Switzerland were making artificial limbs which could rotate and bend using cables, gears, cranks and springs. However, these devices still needed to be adjusted manually. For example, an artificial hand could be cranked shut around a fork, but the person needed another hand to operate the crank.
During the 1960s, manufacturers started to build more functional prostheses by swapping wood and leather for plastics and other artificial materials.
Today's prostheses look and work very differently from those made before the late 20th century. More lightweight and durable materials such as plastic, aluminum, titanium and silicone are commonly used in devices now.
"The introduction of socket designs based on sound biomechanical analyses to take full advantage of the functions and properties of the stump in conjunction with a rationale for alignment undoubtedly represents the greatest achievement in prosthetics since World War II," according to History of Amputation Surgery and Prosthetics.
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