Correction Device Research Articles

Compact Models of Presbyopia Accommodative Errors for Wearable Adaptive-Optics Vision Correction Devices

Subjective accommodation refractive error models are essential for implementing adaptive vision correction devices that utilize varifocal optics. This article describes compact empirical models of subjective accommodative refractive errors in subjects with advanced presbyopia. The models are based on measurements of subjective refractive errors from fifteen presbyopes over the age of 45 using commercially available focus-tunable eyeglasses under three different illumination conditions over a 3.08D accommodation stimulus range. The resulting average residual root-mean-squared (RMS) error values for the best fitting 8-parameter model was 0.25D compared to an average RMS error of 0.4D for the conventional DDF and HHG models. The RMS error for the best-fitting model is below the average refractive error of the human eye.

Синтез и исследование адаптивной системы управления силовыми взаимодействиями в упругих механизмах многозвенных манипуляторов

Предложена методика синтеза адаптивной электромеханической силокомпенсирующей системы управления шарнирно-балансированным манипулятором с многозвенной структурой упругого исполнительного механизма. Приведено математическое описание электромеханической системы с трёхмассовой механической частью. Получены аналитические выражения для определения параметров адаптивного управляющего устройства при изменении массы перемещаемого объекта и жесткости механических передач и звеньев. Проведено исследование механической части манипулятора без электропривода и с применением предложенной адаптивной системы управления усилиями в упругом исполнительном механизме с синтезированным корректирующим устройством при изменении положения и массы перемещаемого груза от 20 до 160 кг.

Application of Nonlinear Correction Method for Attitude Control and Landing Oscillations Prevention

The purpose of this work is to demonstrate the application of the nonlinear correction method to prevent attitude oscillations of flying vehicles. This paper investigates the complications of manual control tasks in aeronautics caused by employing the integral component in the control loop. If the actuators of aircraft controlling surfaces reach their rate limits, the aircraft oscillations can appear for both manually and automatically piloted cases. In this paper, the oscillations alleviation problem is solved using the nonlinear correction method. A general methodology for pilot-induced oscillations prevention is described briefly by the example of an aircraft pitch control system. The obtained pilot model parameters are used for altitude control system examination. The nonlinear systems analysis is carried out by calculating the generalized sensitivity function for the control and disturbance input signal. In the second part, the application of the nonlinear correction method to prevent aircraft and satellite oscillations caused by integrator windup. A comparative analysis of the nonlinear correction and the customary anti-windup feedback is carried out. The results obtained demonstrate that a sequential nonlinear corrective device can be efficiently used to suppress pilot-induced and integrator windup oscillations.

Combination of forsus fatigue resistant device and premolar extraction for the management of a skeletal class II malocclusion

Treatment of class II malocclusion requires accurate diagnosis and treatment planning. This case report outlines the successful management of a growing skeletal class II using Forsus fatigue resistant device for correction of skeletal parameters and premolar extractions for correction of dental parameters. The patient’s profile improved significantly with a 4° reduction in ANB angle. An ideal overjet, overbite and molar relation were also attained.

Expanding of Excimer Laser Photoablation’s Functionality in Ophthalmology

One of the significant weaknesses of excimer laser-based vision correction devices is the difficulty of achieving a required change in the refractive properties of the cornea to sharply focus the image on the retina with distance from the working area (ablation zone) center to the periphery due to a change in the laser beam incidence angle. The study is aimed at improving the quality of laser action on the eye cornea by introducing an optical corrective system into the existing excimer laser vision correction equipment, ensuring the coincidence of the direction of the laser beam incidence on the corneal surface with the normal.It has been shown that the greater the reflection coefficient, the lower the absorbed energy, and the shallower the laser radiation penetration and ablation depths, which reduces the laser action opportunities and quality. When using excimer laser vision correction devices, it has been proposed to change the angle of the laser beam incidence on the cornea with a distance from the working area (ablation zone) center to the periphery during the surgery by introducing an optical corrective system based on a lightweight controllable and movable mirror, which allows achieving the coincidence of the direction of the laser beam incidence on the corneal surface with the normal.The studies have shown that the coincidence of the laser beam incidence on the corneal surface at any point with the normal when using a priori data on the specifics of the patient's eye allows expanding the functional opportunities of excimer laser photoablation, i. e., expand the ablation zone by 30 % and eliminate the possibility of errors caused by the human factor. The technique proposed can be used for excimer laser vision correction according to PRK, LASIK, Femto-LASIK, and other methods. To implement this approach, a patented excimer laser vision correction unit has been proposed with a PCcontrolled optical shaping system comprising galvo motor platforms and galvo mirrors installed on them.

Adaptive optics for high-resolution imaging.

Adaptive optics (AO) is a technique that corrects for optical aberrations. It was originally proposed to correct for the blurring effect of atmospheric turbulence on images in ground-based telescopes and was instrumental in the work that resulted in the Nobel prize-winning discovery of a supermassive compact object at the centre of our galaxy. When AO is used to correct for the eye's imperfect optics, retinal changes at the cellular level can be detected, allowing us to study the operation of the visual system and to assess ocular health in the microscopic domain. By correcting for sample-induced blur in microscopy, AO has pushed the boundaries of imaging in thick tissue specimens, such as when observing neuronal processes in the brain. In this primer, we focus on the application of AO for high-resolution imaging in astronomy, vision science and microscopy. We begin with an overview of the general principles of AO and its main components, which include methods to measure the aberrations, devices for aberration correction, and how these components are linked in operation. We present results and applications from each field along with reproducibility considerations and limitations. Finally, we discuss future directions.

MRI provision for patients with cardiac implantable electronic devices: understanding the real-world administrative requirements of service delivery

Abstract Introduction Patients with cardiac implantable electronic devices (CIEDs) should have access to Magnetic Resonance Imaging (MRI) but are less likely to be referred and hospitals lack provision. A major barrier to service delivery is the administrative demand required to obtain accurate CIED details prior to scheduling. We aimed to understand the administrative requirements of a high-volume Cardiac Device-MRI service to inform the design of an electronic referrals platform that can facilitate workflow. Methods Single centre retrospective audit of a high-volume Cardiac Device-MRI service in a tertiary unit in the UK. Six months of referrals were reviewed for patient and CIED details and barriers met. Referrals were stratified by source, indication, MR-Conditional labelling and referrer. Results Administrative barriers were reviewed for 116 patients with CIEDs referred for MRI (48% cardiac, 52% non-cardiac) between September 2020 and March 2021 (Table 1). Referrers were 47% cardiologists and 53% other specialties. Referral to scan time was 15 days (interquartile range, 8–32). There were no scan-related complications. 34% of referrals contained complete CIED details and 30% stated the MR labelling of the CIED. None incorrectly labelled a CIED as MR-Conditional, but 8% incorrectly labelled as non-MR Conditional. 7 additional days were required to obtain complete CIED details where not provided (involving information requests from two device clinics in 27%), 10% had delays over 2 weeks (maximum 145 days). 35% required 3 or more repeat discussions with referrers after initial referral. Obtaining CIED information for external referrals required 17 days (11–42), compared to 14 (6–35) days for internal referrals (p=0.25). Patients with non-MR Conditional CIEDs required on average 14 days longer to obtain complete referral details than patients with MR-Conditional CIEDs. Even when referrers were aware of non-MR Conditional labelling and received information on risk, 41% required further discussion between patient and referrer regarding risks and benefits of MRI scanning. For cancer referrals, obtaining correct details took 1 day longer than other referrals (p=0.074) and required 2 extra emails to maintain provision within the national time-to-treatment target of 62 days. Missing data was similarly present in referrals from Cardiologists and non-Cardiologists (59% versus 61% respectively), but non-Cardiologists recorded more incorrect CIED details (8% vs 0%). Conclusions Referral for MRI in patients with CIEDs demands significant administrative input to obtain correct device information, leading to delays. These delays are greater for patients with non-MR conditional CIEDs, and data provided is often incorrect or incomplete. This may explain why some patients are not referred for MRI. An online referrals platform has been developed to streamline this process, initially deployed through a network of 60 centres registered in the UK. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): This work is supported by British Heart Foundation Innovations funding (HFHF_016).

Design, Construction and Validation of a Proof of Concept Flexible–Rigid Mechanism Emulating Human Leg Behavior

In most robotics simulations, human joints (e.g., hips and knees) are assumed to be revolute joints with limited range rotations. However, this approach neglects the internal flexibility of the joint, which could present a significant drawback in some applications. We propose a tensegrity-inspired robotic manipulator that can replicate the kinematic behavior of the human leg. The design of the hip and knee resembles the musculoskeletal connections within the human body. Our implementation represents muscles, tendons and ligament connections as cables, and bones as rods. This particular design manipulates muscles to replicate a human-like gait, which demonstrates its potential for use as an anatomically correct assistive device (prosthetic, exoskeleton, etc.). Using the OpenSim 3.0 simulation environment, we estimated the kinematics and structural integrity of the proposed flexural joint design and determined the actuation strategies for our prototype. Kinematics for the prototype include the mechanical limitations and constraints derived from the simulations. We compared the simulation, physical prototype, and human leg behaviors for various ranges of motion and demonstrated the potential for using OpenSim 3.0 as a flexible–rigid modeling and simulation environment.

Research on ballistic and aerodynamic characteristic of uncontrolled trajectory correction device

This paper studies the 125mm tank high explosive projectile equipped with two-dimensional correction device. To investigate the aerodynamic characteristic of two-dimension trajectory correction device before starting the correction device for ballistic control, a mathematical model of the fixed-canard rotation was established and the simulation calculations were performed, which uses a ballistic correction procedure to calculate the possible ballistic deviation caused by the rotational speed. The results show that the trajectory distribution is less than 1m, in the speed interval, and determines the best time to reduce the correction device and control the trajectory according to the change of polar restraining moment.

Combined diffractive optical elements with adjustable optical properties controlled by a relative rotation: tutorial.

A pair of adjacent transmissive diffractive optical elements (DOEs) forms a combined DOE with tunable optical properties, as, for example, a diffractive lens with an adjustable focal length. The optical properties are controlled by a relative movement of the two DOEs, such as a translation or a rotation around the optical axis. Here we discuss various implementations of this principle, such as tunable diffractive lenses, axicons, vortex plates, and aberration correction devices. We discuss the limits of the tuning range and of diffraction efficiency. Furthermore, it is demonstrated how chromatic aberrations can be suppressed by using multi-order DOEs.

Feasibility and Accuracy of Automated Three-Dimensional Echocardiographic Analysis of Left Atrial Appendage for Transcatheter Closure

Procedural success of transcatheter left atrial appendage closure (LAAC) is dependent on correct device selection. Three-dimensional (3D) transesophageal echocardiography (TEE) is more accurate than the two-dimensional modality for evaluation of the complex anatomy of the left atrial appendage (LAA). However, 3D transesophageal echocardiographic analysis of the LAA is challenging and highly expertise dependent. The aim of this study was to evaluate the feasibility and accuracy of a novel software tool for automated 3D analysis of the LAA using 3D transesophageal echocardiographic data. Intraprocedural 3D transesophageal echocardiographic data from 158 patients who underwent LAAC were retrospectively analyzed using a novel automated LAA analysis software tool. On the basis of the 3D transesophageal echocardiographic data, the software semiautomatically segmented the 3D LAA structure, determined the device landing zone, and generated measurements of the landing zone dimensions and LAA length, allowing manual editing if necessary. The accuracy of LAA preimplantation anatomic measurement reproducibility and time for analysis of the automated software were compared against expert manual 3D analysis. The software feasibility to predict the optimal device size was directly compared with implanted models. Automated 3D analysis of the LAA on 3D TEE was feasible in all patients. There was excellent agreement between automated and manual measurements of landing zone maximal diameter (bias, -0.32; limits of agreement, -3.56 to 2.92), area-derived mean diameter (bias, -0.24; limits of agreement, -3.12 to 2.64), and LAA depth (bias, 0.02; limits of agreement, -3.14 to 3.18). Automated 3D analysis, with manual editing if necessary, accurately identified the implanted device size in 90.5% of patients, outperforming two-dimensional TEE (68.9%; P<.01). The automated software showed results competitive against the manual analysis of 3D TEE, with higher intra- and interobserver reproducibility, and allowed quicker analysis (101.9±9.3 vs 183.5±42.7sec, P<.001) compared with manual analysis. Automated LAA analysis on the basis of 3D TEE is feasible and allows accurate, reproducible, and rapid device sizing decision for LAAC.

Impact of implantation depth on outcomes of new-generation balloon-expandable transcatheter heart valves.

Little is known about the impact of the ID on outcomes and device success using balloon-expandable devices. This study sought to analyze the impact of implantation depth (ID) on procedural outcomes. In consecutive patients (n = 969) undergoing transfemoral TAVR with new-generation balloon-expandable prostheses, the mean ID (IDMean) was determined by aortography and categorized into low, correct, and high device position. Outcomes of interest were device success (VARC-2), paravalvular regurgitation (PVR) ≥ moderate, severe prosthesis-patient mismatch (PPM), permanent pacemaker implantation (PPI), and the composite of the three latter outcome measures (COMPPPP). IDMean was greater among patients with PPI (median 4.0 [interquartile range 2.0; 4.0] vs. 3.5 [1.5; 5.5] mm; p = 0.002), severe PPM (3.5 [1.5; 5.0] vs. 4.0 [2.0; 6.0] mm; p = 0.028), and COMPPPP (4.0 [2.0; 6.0] vs. 3.0 [1.5; 5.5] mm; p < 0.001) when compared with the respective groups without these complications. There was no significant association between IDMean and device success or PVR ≥ moderate. Categorization into low (7.3%), correct (90.7%), and high (2.0%) device position showed significant discrimination with an increase of severe PPM, PPI, and COMPPPP with lower position, whereas device success was not significantly affected by position. Only PVR ≥ moderate showed an asymmetric distribution with highest rates in the high and low position group, which was non-significant. However, among patients without correct position the rate of device success was 45.6%. A higher device position was associated with improved outcomes. Malpositioning without functional impairment should not be classified as device failure. The odds ratio of IDMean was calculated by univariate logistic regression for each outcome variable, showing that with higher values of IDMean (i.e., low implantation depth), the risk of severe PPM, PPI, and COMPPPP increases. The bar charts under the heading "Position category" denote the frequency of each outcome measure across patients with high, correct, and low device position. The p values are derived from chi-squared test.

Retinal adaptive optics imaging with a pyramid wavefront sensor.

The pyramid wavefront sensor (P-WFS) has replaced the Shack-Hartmann (SH-) WFS as the sensor of choice for high-performance adaptive optics (AO) systems in astronomy. Many advantages of the P-WFS, such as its adjustable pupil sampling and superior sensitivity, are potentially of great benefit for AO-supported imaging in ophthalmology as well. However, so far no high quality ophthalmic AO imaging was achieved using this novel sensor. Usually, a P-WFS requires modulation and high precision optics that lead to high complexity and costs of the sensor. These factors limit the competitiveness of the P-WFS with respect to other WFS devices for AO correction in visual science. Here, we present a cost-effective realization of AO correction with a non-modulated P-WFS based on standard components and apply this technique to human retinal in vivo imaging using optical coherence tomography (OCT). P-WFS based high quality AO imaging was successfully performed in 5 healthy subjects and smallest retinal cells such as central foveal cone photoreceptors are visualized. The robustness and versatility of the sensor is demonstrated in the model eye under various conditions and in vivo by high-resolution imaging of other structures in the retina using standard and extended fields of view. As a quality benchmark, the performance of conventional SH-WFS based AO was used and successfully met. This work may trigger a paradigm shift with respect to the wavefront sensor of choice for AO in ophthalmic imaging.

Online accurate detection of soluble solids content in navel orange assisted by automatic orientation correction device

Non-destructive online sorting system for fruit quality are gaining importance in the global agro-industry as they allow for optimising harvesting, storage and marketing management decisions. The most commonly used sensing technology is visible-near infrared (Vis/NIR) spectroscopy. However, in online detection, the reproducibility of spectra is easily affected by fruit placement attitude. Up to now, little or no work considered the problem of attitude correction before spectral acquisition. This work aims at filling this gap. In this study, Vis/NIR diffuse transmission technology was used to detect the soluble solids content (SSC) in navel oranges, the analysis models of SSC in navel orange with consistent-orientation (T1: navel upward, T2: navel forward, and T3: navel leaning with an angle about 30°-60°), mixed-orientation (mix of T1, T2 and T3) and corrected-orientation (T2 correction) were established. Partial least square regression (PLSR) combined with different spectral pretreatment and effective wavelengths (EWs) selection methods were used to establish the optimal SSC analytical models. Root mean square error of cross-validation (RMSECV), correlation coefficient of calibration (RC), root mean square error of prediction (RMSEP), correlation coefficient of prediction (RP), residual predictive deviation (RPD) and the ratio of error range (RER) are used as the evaluation indicators of the model. The results show that the inconsistency of the placement attitude affects the prediction accuracy. The mixed-orientation model contains inconsistent placement information of the fruit orientation, and the robustness of the model is improved, but the prediction accuracy decreased. In the consistent-orientation model, the best analytical results can be obtained with the T2 placement orientation. The automatic orientation correction device based on image processing technology can correct the attitude of randomly placed navel orange samples according to the T2 orientation. The analytical accuracy of the model is further improved. In the corrected-orientation model, the best SSC analytical model can be obtained using NWS-MSC (Norris Williams smoothing - multiplicative scattering correction) pretreatment and VCPA (variable combination population analysis) variable selection methods, and RP, RMSEP, RPD and RER of the optimal prediction model were 0.981, 0.313 °Brix, 5.176 and 16.613 respectively. This method can be extended to the online analysis of other spherical fruits.

B-PO04-111 ICE VS TEE-GUIDED LEFT ATRIAL APPENDAGE OCCLUSION WITH WATCHMAN FLX

Watchman FLX has been recently approved for LAAO in the US. While TEE is the standard imaging modality to guide its deployment, ICE - which is already used for transeptal access - can serve as an alternative simplifying the procedure and reducing associated costs. To compare the procedural and clinical outcomes of using ICE vs TEE to guide LAAO with Watchman FLX. The study included consecutive patients who underwent Watchman FLX LAAO with TEE (first n=20 patients) or ICE (the following n=20). LAAO was performed as a standalone procedure (n=7), or in following ablation of extra-LAA sites (n=33). For LAAO, ICE was positioned in the LSPV and in the anterior LA just proximal to the MVA to assess LAA anatomy and guide device deployment. Demographic characteristic, procedure parameters, and 45-days clinical outcomes were compared between TEE- and ICE-guided groups. Age, gender, BMI, and stroke risk where comparable between the two groups. LAAO was successful in all patients, with the correct device size always selected on the first attempt. There was no significant difference in procedural times and volume of iodinated contrast used (ΔICE-TEE: +2 min, 95% CI -21 to 25 min; 95% CI +9 mL, -8 to 25 mL), with a potential clinically relevant reduction in fluoroscopy dose with ICE (ΔICE-TEE: DAP -26264 mGy/cm2, 95% CI -57469 to 4940 mGy/cm2; AK -60 mGy, 95% CI -330 to 209 mGy). This reduction in fluoroscopy dose is mainly secondary to fewer cine acquisition runs with ICE (ΔICE-TEE: -31 secs; 95% CI -86 to 27 secs). There were no significant peri- or early procedural device-related complications in either group. At a median of 8 (6-11) weeks, no device-related thrombosis and 9 small (< 5 mm) peri-device leaks were detected on first the follow-up TEE. The rate of leaks was similar between the groups (TEE, n=4; ICE, n=5). ICE-guided Watchman FLX implant is safe and feasible, with a potential reduction in fluoroscopy dose when compared to TEE.

Case Study on Automatic Power Factor Compensation for Industrial Power

In an electrical power grid, for an equal amount of usable power transmitted, a load with a coffee power factor draws more current than a load with a small power factor. The higher currents increase the loss of energy in the distribution network and require larger wires and other equipment. Due to the costs of larger equipment and waste energy, electrical utilities will usually charge a much higher cost to industrial or commercial customers where a low power factor is present. Low-power factor linear loads (such as induction motors) are often corrected with a passive condenser or inductor network. The present drawn from the system is distorted by non-linear loads, like rectifiers. In such cases, the correction of the active or passive power factor may also counteract the distortion and lift the factor of the facility. The facility factor correction devices may also be installed at a central substation, opened over a distribution grid, or built into power-consuming equipment.

Clubfoot treatment in China before and after the advent of the Ponseti technique: a historical narrative review.

Congenital clubfoot (CF) was first described by Hippocrates in approximately 400 B.C. In ancient China, manipulations were widely used to correct CF, but the outcomes were frequently unsatisfactory with residual deformity even if corrective devices were used. The advent of aseptic surgery and anesthesia has favored the development of different surgical procedures to manage children with CF. Surgical treatment became extremely popular in China during the years 1960–1990 due to the good clinical foot appearance post-surgery. However, the poor mid- to long-term results of surgical treatment facilitated the return of conservative treatment, i.e., the Ponseti technique. Over the past decade, the Ponseti technique has become very popular in China. The Ponseti technique is essentially conservative and it is based on a good understanding of CF pathophysiology. Casts are changed once a week and Achilles tenotomy is performed if equinus persists at the end of treatment. Although highly successful on the short to mid-term, the Ponseti technique is not able to completely eradicate surgery, and recurrence is still possible. As the etiology of CF is still unclear, the first mission for doctors and researchers all over the world is to truly understand the pathogenesis of the deformity. Even though genetics seems to play an important role, successful gene therapy is still a distant goal. This narrative review aims to investigate the history of CF treatment in China, to describe its tortuous process and to potentially inspire new ideas to create new effective methods of treatment.

Novel device for nonsurgical correction of rigid forefoot adduction in children.

Forefoot adduction deformity (FAD) (commonly called metatarsus adductus) is reported as the most common congenital foot deformity in newborns. Early diagnosis and treatment are important in rigid cases, as better outcomes have been reported if treatment was initiated before 9 months of age. While casting and splinting is the current standard of care for nonsurgical management of rigid FAD (RFAD), several orthoses have demonstrated equal benefit. The Universal Neonatal Foot Orthotic (UNFO) brace is below ankle orthosis that provides continuous pressure, thereby correcting the deformity without casting. To the best of our knowledge, UNFO is the first brace that operates below the ankle. The aim of this study was to compare the effectiveness of UNFO shoe to standard serial casting in the treatment of RFAD in infants. Between the years 2012 and 2019 we treated 147 feet (94 patients): 52 using the UNFO shoes and 95 by standard casting and splinting protocol. The treatment groups were compared based on treatment duration, complications, and recurrence of deformity. Mean full-time treatment duration was significantly shorter in the UNFO group, while no significant difference in the total duration of treatment was observed. Similar complication and recurrence rates were demonstrated. In conclusion, treatment with UNFO is equally effective to serial casting. The use of UNFO increases convenience and diminishes social burden, thus providing a distinct advantage over other treatment modalities.

Arbitrary complex retarders using a sequence of spatial light modulators as the basis for adaptive polarisation compensation

We show theoretically how a sequence of spatial light modulators (SLMs) can be used to compensate polarisation and phase errors introduced by a spatially variant homogeneous waveplate with any polarisation eigenmode and arbitrary retardance distribution. The resultant compensation is applicable to all pure input polarisation states. The properties of such a system are easily described using Jones calculus in terms of the retardance distribution on each SLM. However, it is not straightforward to determine from the Jones matrices the arrangements nor the settings of each SLM required to implement an arbitrary spatially variant retarder. In order to address this problem, analytic solutions for the required SLM settings are obtained through the construction of a geometrical model on the Poincaré sphere. These solutions are validated against numerical models. These models can be used, for example, to control a multi-pass SLM system acting as the correction device in an efficient vectorial adaptive optics system.

Auto Strut: a novel smart robotic system for external fixation device for bone deformity correction, a preliminary experience.

PurposeSeveral hexapod external fixators are used in the treatment of bone fracture and deformity corrections. One characteristic of all of them is the requirement for manual adjustment of the fixator struts. The purpose of this study was to introduce a novel robotic system that executes automatic adjustment of the struts.MethodsTen patients were treated for various bone deformities using a hexapod external fixator with the Auto Strut system. This new system automatically adjusts the fixator struts according to a hexapod computer-assisted correction plan. During each visit, the progress of the correction was assessed (clinically and radiographically) and reading of the strut scale numbers was performed and compared with the original treatment plan.ResultsAll patients completed treatment during the follow-up period, achieving all planned correction goals, except from one patient who switched to manual struts due to personal preference. The device alarm system was activated once with no device-related adverse events. Duration of distraction ranged between ten and 90 days with a distraction index ranging between eight and 15 days/cm. Regenerate consolidation time between one and seven months. In total, 48 struts of eight patients were recorded and analyzed. In all, 94% of the final strut number readings presented a discrepancy of 0 mm to 1 mm between planned and actual readings, indicating high precision of the automatic adjustment.ConclusionThis study presents preliminary results, showing that Auto Strut can successfully replace the manual strut adjustment providing important advantages that benefit the patient, the caregiver and the surgeon.Level of EvidenceLevel II