This paper presents a comprehensive comparative analysis of recent advances in smart bone prosthetics. The emphasis is made on the integration of embedded sensors, adaptive control systems, and wireless monitoring into metallic, carbon-based and bioceramic materials. The evaluation of essential characteristics of mechanical strength, durability, and biocompatibility is combined with its integration of smart functionality. The key mechanical properties, such as tensile strength, Young’s modulus, and fatigue life, are reviewed to assess how each material supports long-term prosthetic performance. Concurrently, biocompatibility factors, tissue integration and inflammatory response are examined to ensure safe and effective clinical application. The integrative approach can help clinicians and biomedical engineers to fine-tune the selection of the optimal material-smart system and provide individually tailored combinations to specific patient needs and surgical-operative contexts.