Toward improving residual limb climate within prostheses for persons with lower limb loss: a technical note

Ashley D. Knight*, Brad D. Hendershot, Todd J. Sleeman, Christopher L. Dearth, Urs Schneider, Sara R. Koehler-McNicholas, Kyle Barrons, Eric Nickel, Spencer Mion, John Ferguson, Felix Starker, Billie Savvas Slater, Gregory O. Voss, Karl Koester, Andrew H. Hansen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Individuals with lower limb loss often wear a gel liner and enclosed socket for connecting to a terminal prosthetic device. Historically, a significant limitation to traditional liners and sockets is that they are thermal insulators, thereby trapping heat and moisture within, which can lead to numerous deleterious issues, including loss of suspension and residual limb skin problems, and, in turn, reductions in mobility, function, and overall quality of life. To mitigate these issues, new approaches are therefore needed to enhance the residual limb climate (e.g. breathability and air permeability), allowing the dispersal of heat and moisture from within the liner and socket. Methods: In this study, a multidisciplinary team sought to establish the feasibility of an innovative prosthetic liner-socket system, designed to improve residual limb climate by capitalizing on passive (i.e. nonpowered) ventilation to reduce temperature/moisture and improve socket comfort for persons with transtibial amputations. Focus group meetings, along with an iterative design approach, were implemented to establish innovative design and development concepts that led to a passively ventilated liner-socket system. Conclusions: Ex vivo design has supported the feasibility of developing a passively ventilated liner-socket. To build on these successes, future development and human subjects testing are needed to finalize a commercially viable system. Implementing a passively ventilated liner-socket system that improves residual limb health and comfort, without compromising function or mobility of the user, into standard clinical care may encourage a more active lifestyle and enhance the quality of life for individuals after lower limb loss.

Original languageEnglish
Pages (from-to)202-205
Number of pages4
JournalProsthetics and orthotics international
Issue number2
StatePublished - 1 Apr 2022
Externally publishedYes


  • passively ventilated socket
  • prosthetic socket
  • residual limb health
  • transtibial amputation


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