Metal Struts Research Articles

A FeCrAl-Al2O3 Composite Produced Via Laser Powder Bed Fusion of a Mixed Powder for Porous Catalyst Scaffolds

Abstract This study proposes a novel approach for synthesizing and etching bicontinuous FeCrAl-Al2O3 composites as a means for replacing FeCrAl foams as catalyst scaffolds in biodriven alcohol reactors for jet-fuel production. Conventional FeCrAl foams suffer from poor availability and consequent high costs. New additive manufacturing techniques provide an opportunity to produce tailored foams at reasonable times and at acceptable costs. This research aimed to generate a porous FeCrAl structure by etching a bicontinuous FeCrAl-Al2O3 composite produced by laser powder bed fusion of amalgamated FeCrAl and Al2O3 powders. The composite powder for laser powder bed fusion is created by ball-milling FeCrAl and Al2O3 powders. This research focuses on achieving a bi-continuous FeCrAl-Al2O3 structure, essential for the selective removal of the ceramic phase. The influence of laser processing parameters on the microstructure was examined across a range of laser powers (60–120 W) and scan speeds (100–400 mm/s), showing that higher powers and speeds produce finer metal struts. A bi-continuous microstructure was consistently obtained, marking a key achievement. The Al2O3 removal process involved a two-step etching method using hydrochloric and phosphoric acids, tested across various etching times. The alumina phase was reduced from 36 vol% to 17 vol% (corresponding to an increase in porosity from 24 vol% to 43 vol%), showing the potential for use as a porous catalyst scaffold. This research demonstrates the potential for using additive manufacturing to produce porous FeCrAl structures capable of replacing hard-to-source FeCrAl foams.

Compressive behavior of triaxially braided metal-CFRP hybrid lattice structures

Cellular approaches facilitate the flexible design of materials with desirable properties that may be manufactured from single polymers, metals, and, recently, fiber-reinforced composites. This paper describes cellular materials with metal and carbon fiber-reinforced plastic (CFRP) struts. Composite lattice tubular structures were automatically braided, and the effects of axial CFRP yarns on the compressive behaviors of braided lattices were studied. Metal wire-reinforced plastic and metal rods served as axial yarns when preparing hybrid triaxially braided metal-CFRP lattices. The effects of the axial yarns in polyurethane (PU) foam-filled samples were also assessed. Ten braided structures were manufactured, and their compressive behavior and energy absorption were evaluated by axial compression tests. Finite element (FE) simulations were used to investigate deformation, buckling, and damage. Addition of axial CFRP yarns improved the compressive properties; the specific absorbed energy (SAE) increased by 16%. Hybridization further enhanced the SAE by 62%.

Verification of the usefulness of shape acquisition using plastic casts during fabrication of a metal strut ankle-foot orthosis.

[Purpose] When fabricating metal strut ankle-foot orthoses, previous studies have reported that shape acquisition is more efficient with a plastic cast than with a plaster of Paris bandage; however, this has not been quantitatively evaluated. This study aimed to clarify the usefulness of plastic casts by quantitatively evaluating the time spent and body shape accuracy among different methods of shape acquisition. [Participants and Methods] We compared the time spent and acquired shapes among the plaster of Paris bandage, plastic cast, and trace methods in 30 limbs of 15 healthy participants. Three-dimensional scans of the lower legs of participants were used as references to compare the three methods. [Results] The plastic cast method required less time than the plaster of Paris bandage method and provided a more accurate shape than the trace method did. However, the plastic cast method resulted in an increased overall width and circumferential diameter owing to the thickness of the stockinette and plastic cast. [Conclusion] The plastic cast method may be useful in reducing the time and burden of fabricating metal strut ankle-foot orthoses. The use of slightly narrow dimensions during the metal strut bending process can account for the increased width and diameter.

Pattern of Endothelialization in Left Atrial Appendage Occluder by Optic Coherence Tomography: A Pilot Study.

Implantation of the left atrial appendage occluder (LAAO) has been proven to prevent stroke effectively in patients with atrial fibrillation who cannot tolerate anticoagulants. Incomplete endothelization of LAAO may cause device-related thrombus, and currently no good image modality exists to clearly see LAAO endothelialization. We aimed to use coronary optic coherence tomography (OCT) to visualize LAAO endothelialization. We enrolled 14 patients (72.8±9.4 years old) undergoing pulmonary vein isolation with a preexisting LAAO implanted more than 1 year ago (5 Watchman and 9 Amulet). After pulmonary vein isolation, we did OCT via steerable sheath and coronary guiding catheter to adjust OCT probe location and injected contrast medium to visualize the LAAO surface. Invitro testing was also performed to see the bare occluder. Invitro OCT showed the surface of the bare device as an interrupted granule pattern, which included the Watchman surface polytetrafluoroethylene membrane string, Amulet disc metal strut, and inner polytetrafluoroethylene membrane string. In the implanted Watchman, OCT showed endothelialization as a smooth surface layer with noninterrupted coarser granules. In the implanted Amulet, OCT showed endothelialization as thin (early) or thick (late) endothelialization layer covering struts with OCT shadows. Among patients with Watchman, 2 showed no, 2 early, and 1 complete endothelialization. Among patients with Amulet, 2 showed no, 3 early, and 4 late endothelialization. We demonstrated the feasibility of OCT to visualize LAAO endothelization with high resolution. Further studies are needed to determine antithrombotic regimens if incomplete endothelization is detected. A new OCT catheter may be designed specifically for LAAO.

Preclinical Evaluation of an Everolimus-Eluting Bioresorbable Vascular Scaffold Via a Long-Term Rabbit Iliac Artery Model.

Biodegradable poly (l-lactic acid) (PLLA), a bio safe polymer with a large elastic modulus, is widely used in biodegradable medical devices. However, because of its poor mechanical properties, a PLLA strut must be made twice as thick as a metal strut for adequate blood vessel support. Therefore, the mechanical properties of a drug-eluting metal-based stents (MBS) and a bioresorbable vascular scaffolds (BVS) were evaluated and their safety and efficacy were examined via a long-term rabbit iliac artery model. The surface morphologies of the MBSs and BVSs were investigated via optical and scanning electron microscopy. An everolimus-eluting (EE) BVS or an EE-MBS was implanted into rabbit iliac arteries at a 1.1:1 stent-to-artery ratio. Twelve months afterward, stented iliac arteries from each group were analyzed via X-ray angiography, optical coherence tomography (OCT), and histopathologic evaluation. Surface morphology analysis of the EE coating on the MBS confirmed that it was uniform and very thin (4.7μm). Comparison of the mechanical properties of the EE-MBS and EE-BVS showed that the latter outperformed the former in all aspects (radial force (2.75 vs. 0.162N/mm), foreshortening (0.24% vs. 1.9%), flexibility (0.52 vs. 0.19N), and recoil (3.2% vs. 6.3%). At all time points, the percent area restenosis was increased in the EE-BVS group compared to the EE-MBS group. The OCT and histopathological analyses indicate no significant changes in strut thickness. BVSs with thinner struts and shorter resorption times should be developed. A comparable long-term safety/efficacy evaluation after complete absorption of BVSs should be conducted.

Design of a segmented custom ankle foot orthosis with custom-made metal strut and 3D-printed footplate and calf shell.

3D-printing is a potential manufacturing process for optimizing the design and manufacture of ankle foot orthosis (AFOs). The feasibility of an AFO with interchangeable strut that is suitable for 3D-printing is created and evaluated. A segmented AFO with 3D-printed custom footplate and calf shell connected by a custom-made strut is studied. The duration of a healthy subject wearing the 3D-printed segmented AFO in daily activities is used to evaluate the feasibility and durability to integrate 3D-printed AFOs into orthotics practice. The 3D-scanning of a patient's leg is first conducted. The scanned 3D surface is modified by creating the clearance around bony prominences and trimlines for the footplate and calf shell. The footplate has a custom-shaped inside to match with the foot and a standard shape outside at the top to match and connect with the strut. For the calf shell, the inside shape is custom fit with the shank and the outside shape is standard to connect with the strut. Material extrusion is the 3D-printing process selected. Tree-like support structures are used to avoid the use of soluble support material and to eliminate the risk of residual chemical solvent in the orthosis. The segmented AFO with material extrusion footplate and calf shell was tested in a healthy subject with an active lifestyle, offering comfort, and stability for over 4 months without breakage. This segmented AFO is durable, requires short 3D-printing time, and enables the quick adjustment of bending stiffness via an interchangeable strut design.

Favorable mid-to-long-term results of impaction bone grafting using a fresh frozen allograft bone with cemented stem for the treatment of Paprosky IV femoral bone defects

BackgroundFemoral revision surgery in patients with substantial bone loss is challenging. Impaction bone grafting using a cemented stem can be a good solution for reconstruction of the femur with poor bone stock and extensive bone loss. This study aimed to evaluate the mid-to-long-term clinical and radiographic results of impaction bone grafting using a cemented stem for Paprosky IV femoral bone defects. MethodsThirteen patients (13 hips) who underwent revision total hip arthroplasty with impaction bone grafting using a cemented stem and were followed up for at least 5 years were enrolled in this study. In all patients, a sufficient amount of fresh frozen bone of good quality was used. When cortical segmental defects were present, peripheral reinforcement with metal mesh and strut allograft was performed. The average follow-up duration was 11.1 (range, 5.3–15.1) years. The clinical and radiographic outcomes were reviewed at the final follow-up. ResultsThe average Harris hip score was 82.5 (range, 79–94), and the average University of California, Los Angeles activity score was 5.6 (range, 4–8) at the final follow-up. Radiographic assessment revealed an average femoral component subsidence level of 0.67 (range, 0.05–2.81) mm. There were no complications, except one case (7.6%) of periprosthetic fracture. ConclusionsImpaction bone grafting using a cemented stem yielded excellent mid-to-long-term outcomes. It is a reliable technique for Paprosky IV femoral bone defects, and even when severe femoral cortical bone defects are present, long-term stability can be obtained using a metal mesh and/or strut allograft.

Sternocostal instability after Ravitch repair in adolescents; 3 case-reports and a review of surgical techniques in the literature.

Background:Ravitch repair is a common surgical procedure to correct chest wall deformities. In this procedure, a subperichondreal cartilage resection of the deformed parasternal cartilage, and if necessary a repositioning of the sternum, is performed. Insufficient regeneration of the resected cartilage may result in sternocostal instability or even floating sternum. This rare complication presents with symptoms of pain and exercise intolerance.Methods:We describe sternocostal instability in 3 adolescent patients after the Ravitch procedure for pectus carinatum and reviewed the literature on this topic.Results:Our patients suffered different degrees of instability. In all cases, we eventually achieved a satisfactory outcome. There is little literature on sternocostal instability. It is a rare complication, mainly occurring after reoperation by damaging the perichondrium.Conclusions:Malunion of costal cartilage is a rare complication of open pectus repair. To achieve the best regeneration and stability of the sternum, less extended resection of cartilage should be performed and the number of cartilages resected should be limited. The perichondrium must be kept intact. Autologous grafts, growth-enhancing materials, and metal or bioabsorbable struts may contribute to stabilization and regeneration of the cartilage.

In Vitro and In Vivo Testing of Zinc as a Biodegradable Material for Stents Fabricated by Photo-Chemical Etching

There is an increasing interest in biodegradable metal implants made from magnesium (Mg), iron (Fe), zinc (Zn) and their alloys because they are well tolerated in vivo and have mechanical properties that approach those of non-degradable metals. In particular, Zn and its alloys show the potential to be the next generation of biodegradable materials for medical implants. However, Zn has not been as well-studied as Mg, especially for stent applications. Manufacturing stents by laser cutting has become an industry standard. Nevertheless, the use of this approach with Zn faces some challenges, such as generating thermal stress, dross sticking on the device, surface oxidation, and the need for expensive thin-walled Zn tubing and post-treatment. All of these challenges motivated us to employ photo-chemical etching for fabricating different designs of Zn (99.95% pure) stents. The stents were constructed with different strut patterns, made by photo-chemical etching, and mechanically tested to evaluate radial forces. Stents with rhombus design patterns showed a promising 0.167N/mm radial force, which was comparable to Mg-based stents. In vitro studies were conducted with uncoated Zn stents as control and Parylene C-coated Zn stents to determine corrosion rates. The Parylene C coating reduced the corrosion rate by 50% compared to uncoated stents. In vivo studies were carried out by implanting photo-chemically etched, uncoated Zn stent segments subcutaneously in a C57BL/6 mice model. Histological analyses provided favorable data about the surrounding tissue status, as well as nerve and blood vessel responses near the implant, providing insights into the in vivo degradation of the metal struts. All of these experiments confirmed that Zn has the potential for use in biodegradable stent applications.

Patients with platelet aggregation inhibitors in the dental office

Antiplatelet agents with the active ingredients acetylsalicylic acid (Aspirin® protect 100), clopidogrel (Iscover®, Plavix®), prasugrel (Efient®) or ticagrelor (Brilique™) prevent the clumping of platelets and thus the formation of small clots at constrictions of the coronary arteries or on the metal struts of stents in the coronary artery or in bypass grafts. Large-scale studies have shown that taken regularly, these drugs can extend life and help prevent heart attacks. Especially in patients with newly implanted stents, the combination of the above-mentioned agents prevents sudden complete occlusion of the vessel concerned. By paying careful attention to contraindications and pursuing the early detection of possible side effects, drug-induced complications can be prevented.

Comparative studies of different types of osteosynthesis on the human corpse preparation in bilateral antero-lateral flail chest

IntroductionBilateral flail chest injuries are challenging in treatment and comparatively often require an operative stabilization of the anterior chest wall to re-establish normal physiological conditions of the chest wall in shape and statics. Various procedures have been described which are technically sophisticated for the surgeon. Consequently there is an increasing interest in potentials of operative care and their effectiveness on the anterolateral chest wall. Materials and methods12 Human cadavers were prepared and the natural Sternum Position (NP) was marked. A digital probe was fixed to the sternum at the height of the 4th intercostal space in order to measure and compare the stability of the thorax. Readings were taken of the sternal displacement at 1–5cm sagittal distance from NP in starting conditions and from every combination of materials. Serial osteotomies were performed on 2 locations on ribs 2–8 to induce bilateral flail chest.Afterwards the stabilization was achieved with different implants:–Transsternal metalstrut.–Several combinations of locking plate fixation. ResultsThe osteotomies lead to a subsidence of the sternum occurred to almost 75 mm from NP which corresponds to a maximal unstable situation. The unstable chest wall showed substantially more stabilization through the use of locking plates. Our materialcombinations showed a stability of up to 60% of normal. The more ribs were treated osteosynthetically, the higher the stability of the chest wall. Discussion and conclusionsLocking plate fixation offers anatomically realignment of the ribs whereas metal strut support only lifts up the chest wall, but could not provide realignment of the dislocated ribs.

A new strategy for enhanced latent heat energy storage with microencapsulated phase change material saturated in metal foam

Traditional organic phase change materials (PCMs) possess the merits of high latent heat and chemical stability, but suffer from low thermal conductivity and volume expansion during phase transition. In this study, an enhanced energy storage technique with microencapsulated phase change material (MEPCM) saturated in metal foam is proposed to address these issues. The flow and thermal characteristics of MEPCM/foam under different foam geometries are experimentally extracted by means of comparing with two control groups, i.e., pristine PCM and PCM/foam modules. Particularly, the local thermal non-equilibrium effect between metal strut and MEPCM is analyzed. Results indicate that temperature reduction of 45°C for heated surface is achieved by MEPCM/foam composite due to the thermal conductivity enhancement by metal foam. However, this better thermal control performance is obtained at the cost of shrinking the thermal management time. The natural convection of core PCM is suppressed in the MEPCM shell during/after the melting process. The thermal non-equilibrium is more pronounced inside MEPCM/foam than in PCM/foam module due to the contact thermal resistance between strut and MEPCM particle. Lower porosity composite has lower surface temperature attributed to the more dominant role of combined heat conduction.

DESIGN ANALYSIS OF LOWER CONTROL ARM OF MAC PHERSON SUSPENSION SYSTEM

The most important component in vehicle is suspension system which directly affects the safety performance and noise level. Suspension arm is one of the most important components in the suspension system. It is fitted in various types of the suspensions like Macpherson wishbone or double wishbone suspensions. The lower control arm is a wishboneshaped metal strut that attaches the wheel to the vehicles frame. In order to determine the deformation and stress distribution in the current design the finite element analysis is carried out. The baseline model of the lower control arm is created by using solid modeling software viz. CATIA. ANSYS Workbench is used for Finite Element Analysis This study deals with Finite Element Analysis of the Lower control arm of Mac pherson suspension system.

DESIGN, ANALYSIS AND OPTIMIZATION OF BRAKE DISC MADE OF COMPOSITE MATERIAL FOR A MOTOR CYCLE

The most important component in vehicle is suspension system which directly affects the safety performance and noise level. Suspension arm is one of the most important components in the suspension system. It is fitted in various types of the suspensions like Macpherson wishbone or double wishbone suspensions. The lower control arm is a wishboneshaped metal strut that attaches the wheel to the vehicles frame. In order to determine the deformation and stress distribution in the current design the finite element analysis is carried out. The baseline model of the lower control arm is created by using solid modeling software viz. CATIA. ANSYS Workbench is used for Finite Element Analysis This study deals with Finite Element Analysis of the Lower control arm of Mac pherson suspension system.

Investigation of Buckling Capacity of Metal Materials Manufactured by Laser 3D Printing

The buckling criterion for 3D printed metal materials is studied experimentally in this paper. Several metal columns are manufactured using a laser concept 3D printer using different sample orientations. The maximum length of the specimens is limited to 90mm. A standard buckling test is designed using pin-ended struts. The applied compressive force is measured versus the vertical displacement for all specimens. The critical force for each thickness and printing orientation is obtained by averaging the results obtained from five specimens for each case. It is observed that the buckling capacity of the 3D printed metal struts is strongly influenced by the printing direction. It can be concluded that, for these structures, buckling is a dominant behavior and the printing direction needs to be considered during the design process.

Intraductal Fenestration of Biliary Metal Stents Using Argon Plasma to Facilitate Bilateral Hilar Stenting

Background: When placed across the biliary confluence, uncovered self-expanding metal stents (SEMS) may impede access to the contralateral intrahepatic ducts. In particular it is difficult to place additional plastic or metal stents across multiple adjacent cells of a hilar SEMS. Argon plasma has been used to trim biliary SEMS. However, the use of argon plasma for intraductal fenestration of biliary metal stents has not been described. Case report: A 38-year-old man with hilar cholanogiocarcinoma presented with cholangitis and right lobe liver abscesses. He had been previously treated with placement of multiple closed-cell, uncovered SEMS extending from duodenum to left hepatic duct. A percutaneous transhepatic catheter was placed into an abscess cavity, which communicated with right hepatic ducts. Subsequently a percutaneous transhepatic guidewire was advanced through the hilar SEMS interstices and into the duodenum. During ERCP a temporary plastic stent was placed into the left main duct for venting of argon gas. The percutaneous guidewire was then grasped with a snare and brought out via the mouth. Choledochoscopy was then performed using a pediatric gastroscope which was advanced over the guidewire into the existing SEMS up to the level of the hilum. Metal struts of the embedded SEMS were seen crisscrossing over the right duct orifice. The visible SEMS wires were fenestrated using a pediatric argon plasma coagulation probe at power of 80 W and flow 0.3 L/min, and further unwoven with a pediatric biopsy forceps. Argon gas vented from the percutaneous biliary sheath as well as the left hepatic duct stent. Subsequently plastic stents were placed via a duodenoscope into 4 separate right intrahepatic ducts, each of which was accessed across adjacent interstices of the SEMS. The patient had rapid clinical improvement and a follow-up computed tomography at 4 weeks showed resolution of liver abscesses. Conclusion: Fenestration of hilar biliary SEMS using argon plasma under direct endoscopic visualization can facilitate bilateral hilar stent placement in patients with complex malignant obstruction of the central intrahepatic ducts. Argon plasma has been used to trim biliary and rectal SEMS. The use of argon plasma for endoscopic fenestration of duodenal stents to facilitate ERCP has also been reported. Our case extends the application of this technique by describing intraductal fenestration of an indwelling biliary SEMS to accomplish bilateral hilar stenting.

A Rare Complication of TEVAR Performed for Complicated Acute Stanford B Aortic Dissection

Objectives: Management of aortic dissection with novel endovascular techniques (thoracic endovascular aortic repair, TEVAR) as a less invasive alternative to conventional repair has gained widespread acceptance. However, experience for complicated, the aortic arch involving, type B dissection is still limited. We present a potential complication of this procedure. Case Presentation: We report the case of a 76-year-old frail female referred to our hospital due to a large posttraumatic pleural effusion on her left side. Emergency computed tomography (CT) upon arrival revealed an acute Stanford type B aortic dissection with retrograde affliction/hematoma of the aortic arch. Due to relevant comorbidity we opted for a hybrid aortic arch repair with an initial debranching-procedure (End-to-side Y-graft from ascending aorta with end-to-end anastomoses to brachiocephalic artery and left common carotid artery, left carotid-subclavian bypass and TEVAR. After successful extubation and an initially uneventful course, the patient developed relevant blood loss and respiratory distress by postoperative day 3. CT-scan confirmed progressing hematothorax, which was successfully treated by thoracoscopy. Six days later, cardiac arrest led to resuscitation and a CT scan revealed pericardial tamponade and active bleeding arising from the ascending aorta close to the bypass anastomosis. The patient was immediately taken to the OR and extracorporeal bypass was initiated under resuscitation. Surgery revealed a perforation of the ascending aorta, caused by the rigid struts of the implanted stent. Under hypothermia (28°C) and antegrade cerebral perfusion via the bypass graft, the supra-commissural ascending aorta was replaced with a Dacron prosthesis, which was then anastomosed to the stent prosthesis excluding the rigid metal struts. The bypass to the cerebral arteries was reanastomosed in an end-to-side technique. Further ICU course was complicated by acute renal failure requiring hemodialysis and respiratory failure. Six weeks later, her general condition was vastly improved and she was discharged after discontinuation of hemodialysis. Conclusion: Despite being widely considered as a less invasive and less dangerous alternative to conventional aortic repair, TEVAR still has relevant risks especially in treatment of pathologies of the aortic arch. Further experience with this technique is required prior to routine implementation.

In-stent Restenosis: COMBO Stent May Guarantee a Proper Healing

<p>The risk of ISR appears to be related to several factors which cooperate synergistically; among these factors an important role is played by: the metal struts of the stent and the consequent inflammatory stress on the vascular wall which favors an excessive neointimal proliferation that "attacking" the stent struts, progressively and critically reduce the vessel lumen.<br />Drug eluting balloon is the gold standard in this setting due to the absence of metallic struts. COMBO stent could be a viable alternative which may properly compare to DEB in the ISR treatment: one of a kind, because it has a dual therapy action, synergistically combining the effect of sirolimus with the presence of CD34+ antibodies on the surface of its struts, capturing circulating endothelial progenitor cells (EPCs), so mobilized EPCs differentiate into functional endothelium and allowing a homogeneous neointimal formation.<br /> Here we are presenting an intriguing case of a ISR treated successfully with COMBO and confirmed by 5-months angiographic and IVUS follow-up. </p>

Next generation covered stents made from nanocomposite materials: A complete assessment of uniformity, integrity and biomechanical properties

Covered stents are stents wrapped with a thin polymeric membrane, and are typically used to treat vessel aneurysms and seal perforated arteries. Current covered stents suffer from restenosis due to limitations in material and fabrication methods which leaves metallic struts directly exposed to blood. We have developed a biocompatible and haemocompatible nanocomposite polymer, polyhedral oligomeric silsesquioxane poly(carbonate-urea) urethane (POSS-PCU). We devised a novel combination of ultrasonic spray atomisation system and dip-coating process to produce small calibre covered stents with metal struts fully embedded within the membrane, which also yields greater coating uniformity. Stent-polymer bonding was enhanced via silanisation and coating of reactive pre-polymer. Platelet studies supported the non-thrombogenicity of POSS-PCU. Biomechanical performances including diametrical compliance, bending strength, radial strength and recoil were evaluated and optimised. This proof-of-principle manufacturing technique could lead to the development of next-generation small calibre adult and paediatric covered stents. These stents are currently undergoing preclinical trial. From the Clinical EditorThe use of stents to treat vascular diseases is now the standard of care in the clinical setting. Nonetheless, a major problem of the current stents is the risk of restenosis and thrombosis. The authors developed a nanocomposite material using polyhedral oligomeric silsesquioxane and poly(carbonate-urea) urethane (POSS-PCU) and incorporated into metallic stents. Preliminary data have already shown promising results. It is envisaged that this would further lead to better stent technology in the future.

A Comparison of Knee-Ankle-Foot Orthoses with Either Metal Struts or an Adjustable Posterior Strut in Hemiplegic Stroke Patients

We investigated differences in factors affecting judgments regarding the creation of new adjustable posterior strut knee-ankle-foot orthoses (APS-KAFO) and knee-ankle-foot orthoses with metal struts (traditional KAFO) for hemiplegic stroke patients for whom KAFO were created in rehabilitation wards. Subjects were 50 patients with hemiplegia due to new-onset stroke (cerebral infarction: n=25, cerebral hemorrhage: n=25) who were prescribed KAFO. Patient ages ranged from 36 to 90years, and the mean duration from stroke onset to hospitalization was 28.8±13.8days. Neurologic symptoms, cognitive function, activities of daily living, duration from hospitalization to orthosis creation, hospitalization duration, walking ability at discharge, outcome after discharge, and so forth were compared. Fourteen patients were prescribed APS-KAFO, and 36 were prescribed traditional KAFO. Those prescribed APS-KAFO had somewhat milder neurologic symptoms and cognitive dysfunction and a shorter hospitalization duration than those prescribed traditional KAFO. Patients prescribed APS-KAFO also had a higher score and efficiency on functional independence measure at admission and discharge. Walking independence at discharge was seen in 8 of the 14 patients for whom APS-KAFO were created and 8 of the 36 patients for whom traditional KAFO were created. APS-KAFO was chosen for patients with a high level of activity in the ward and with a higher likelihood of acquiring walking ability using APS-AFO at discharge, whereas traditional KAFO tended to be chosen for patients with relatively severe symptoms who were not expected to acquire practical walking ability.