A 62-year-old female with a transtibial amputation is examined in physical therapy. The patient has been using a roll-on silicone liner inside of her prosthesis. What is a potential disadvantage of this type of liner?

• A. Increased shear force on the residual limb
• B. Reduced padding over bony prominences
• C. Heat buildup, especially in warmer climates
• D. Potential trauma to the suture line

Answer: (C)

Heat buildup under the liner is a key drawback of roll-on silicone liners. These liners sit directly against the skin and create an occlusive barrier inside the socket, which slows evaporation of sweat and traps heat. In warmer climates or with extended wear, the residual limb can overheat, leading to increased sweating, skin maceration, irritation, and a higher risk of skin breakdown. This thermal issue often limits how long the prosthesis can be worn comfortably.

The other potential downsides are less tied to the liner’s nature. Silicone liners tend to provide padding and reduce shear at the skin–socket interface, rather than increase it. Trauma to a suture line is more a concern in the immediate post-surgical period than in someone with an established liner, and isn’t a characteristic drawback of this liner type.