Bioinspired Design of 3D-Printed Cellular Metamaterial Prosthetic Liners for Enhanced Comfort and Stability.

Traditional prosthetic liners are often limited in customization due to constraints in manufacturing processes and materials. Typically made from non-compressible elastomers, these liners can cause discomfort through uneven contact pressures and inadequate adaptation to the complex shape of the residual limb. This study explores the development of bioinspired cellular metamaterial prosthetic liners, designed using additive manufacturing techniques to improve comfort by reducing contact pressure and redistributing deformation at the limb-prosthesis interface. The gyroid unit cell was selected due to its favorable isotropic properties, ease of manufacturing, and ability to distribute loads efficiently. Following the initial unit cell identification analysis, the results from the uniaxial compression test on the metamaterial cellular samples were used to develop a multilinear material model, approximating the response of the metamaterial structure. Finite Element Analysis (FEA) using a previously developed generic limb-liner-socket model was employed to simulate and compare the biomechanical behavior of these novel liners against conventional silicone liners, focusing on key parameters such as peak contact pressure and liner deformation during donning, heel strike, and the push-off phase of the gait cycle. The results showed that while silicone liners provide good overall contact pressure reduction, cellular liners offer superior customization and performance optimization. The soft cellular liner significantly reduced peak contact pressure during donning compared to silicone liners but exhibited higher deformation, making it more suitable for sedentary individuals. In contrast, medium and hard cellular liners outperformed silicone liners for active individuals by reducing both contact pressure and deformation during dynamic gait phases, thereby enhancing stability. Specifically, a medium-density liner (10% infill) balanced contact pressure reduction with low deformation, offering a balance of comfort and stability. The hard cellular liner, ideal for high-impact activities, provided superior shape retention and support with lower liner deformation and comparable contact pressures to silicone liners. The results show that customizable stiffness in cellular metamaterial liners enables personalized design to address individual needs, whether focusing on comfort, stability, or both. These findings suggest that 3D-printed metamaterial liners could be a promising alternative to traditional prosthetic materials, warranting further research and clinical validation.