The loss of a lower limb due to amputation is often the end of a long period of illness for older patients [
3,
6]. Therefore, it poses a physically as well as psychologically demanding situation [
6,
18]. Rehabilitation of these patients is a challenge, but nevertheless indispensable in order to enable the amputees to participate in everyday life. A major part of this rehabilitation process is the provision of a fitting and easy to use prosthesis system [
12]. When designing and developing a suitable prosthesis many different problems, such as pistoning, extensive rotation and translation, walking pattern, qualities of residual skin and soft tissue have to be taken into account [
10,
11]. A major role in addressing these issues depends on selecting an appropriate suspension system [
8,
9]. In the late 1980s, the USA and Iceland developed new models of silicone suspension systems, including the 3‑S system [
7] and the Icelandic roll-on silicone socket (ICEROSS system, IRS [ICEROSS, Ossur, Reykjavik, Iceland]) [
14] to address these problems. The effects of these systems have already been proven for transfemoral amputees [
16] and even transtibial amputees [
5]. Nevertheless, systematic reviews do not support liner systems as a general solution without reservation [
4,
13]. This study of 75 transtibial amputees aimed to show the effect of prostheses fitted with a silicone suspension interface (ICEROSS, Ossur, Reykjavik, Iceland) on walking distance, satisfaction of use and duration of daily use in a large patient group.