I know of at least four one legged cyclist's one rides with just the one leg and a stump [walking stick strapped to top tube, another two with complicated titanium fittings similar to guy in your photo and one of my clubmates Clive who has his own knee but a prosthetic attachment for lower leg and foot.
He created a stir outside a cafe in Belgium after getting off his bike from 40 miles in the rain he unstrapped his leg and tipped out about a pint of water
I know a chap that rides MTB, and he is missing a leg and an arm, so he has a few customisations to his bike. Also has a Fox shock in both of his false limbs. He regularly races, but doesn't manage to get many laps in. I'd post a pic if I was at home.
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