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Christian M. Puttlitz

Bio: Christian M. Puttlitz is an academic researcher from Colorado State University. The author has contributed to research in topics: Viscoelasticity & Intubation. The author has an hindex of 42, co-authored 164 publications receiving 5861 citations. Previous affiliations of Christian M. Puttlitz include University College of Engineering & University of Iowa.


Papers
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Journal ArticleDOI
TL;DR: It is demonstrated that the new cortical trajectory and screw design have equivalent pullout and toggle characteristics compared with the traditional trajectory pedicle screw, thus confirming preliminary clinical evidence.

458 citations

Journal ArticleDOI
TL;DR: Anterior repairs of the supraspinatus tendon had significantly stronger biomechanical behavior than posterior repairs and had a significantly higher ultimate tensile load than the three types of single-row fixation stitches.
Abstract: Background: Recent studies have shown that arthroscopic rotator cuff repairs can have higher rates of failure than do open repairs. Current methods of rotator cuff repair have been limited to single-row fixation of simple and horizontal stitches, which is very different from open repairs. The objective of this study was to compare the initial cyclic loading and load-to-failure properties of double-row fixation with those of three commonly used single-row techniques. Methods: Ten paired human supraspinatus tendons were split in half, yielding four tendons per cadaver. The bone mineral content at the greater tuberosity was assessed. Four stitch configurations (two-simple, massive cuff, arthroscopic Mason-Allen, and double-row fixation) were randomized and tested on each set of tendons. Specimens were cyclically loaded between 5 and 100 N at 0.25 Hz for fifty cycles and then loaded to failure under displacement control at 1 mm/sec. Conditioning elongation, peak-to-peak elongation, ultimate tensile load, and stiffness were measured with use of a three-dimensional tracking system and compared, and the failure type (suture or anchor pull-out) was recorded. Results: No significant differences were found among the stitches with respect to conditioning elongation. The mean peak-to-peak elongation (and standard error of the mean) was significantly lower for the massive cuff (1.1 ± 0.1 mm) and double-row stitches (1.1 ± 0.1 mm) than for the arthroscopic Mason-Allen stitch (1.5 ± 0.2 mm) (p < 0.05). The ultimate tensile load was significantly higher for double-row fixation (287 ± 24 N) than for all of the single-row fixations (p < 0.05). Additionally, the massive cuff stitch (250 ± 21 N) was found to have a significantly higher ultimate tensile load than the two-simple (191 ± 18 N) and arthroscopic Mason-Allen (212 ± 21 N) stitches (p < 0.05). No significant differences in stiffness were found among the stitches. Failure mechanisms were similar for all stitches. Rotator cuff repairs in the anterior half of the greater tuberosity had a significantly lower peak-to-peak elongation and higher ultimate tensile strength than did repairs on the posterior half. Conclusions: In this in vitro cadaver study, double-row fixation had a significantly higher ultimate tensile load than the three types of single-row fixation stitches. Of the single-row fixations, the massive cuff stitch had cyclic and load-to-failure characteristics similar to the double-row fixation. Anterior repairs of the supraspinatus tendon had significantly stronger biomechanical behavior than posterior repairs. Clinical Relevance: The results of this study support the concept that double-row fixation can improve the initial fixation strength of arthroscopic rotator cuff repairs.

340 citations

Journal ArticleDOI
15 Nov 2002-Spine
TL;DR: The results clearly indicate the screw–rod system’s equivalence in reducing relative atlantoaxial motion in a severely destabilized upper cervical spine, as compared with the transarticular screw–wiring construct.
Abstract: STUDY DESIGN An in vitro biomechanical study of C1-C2 posterior fusion techniques was conducted using a cadaveric model. OBJECTIVE To investigate and compare the acute stability afforded by a novel rod-based construct that uses direct polyaxial screw fixation to C1 and C2 with contemporary transarticular screw and wire techniques. SUMMARY AND BACKGROUND DATA Acute stability of the atlantoaxial complex is required to achieve bony consolidation. Various forms of posterior wiring were the first standardized procedures advocated to achieve C1-C2 fixation, but because of insufficient construct stability, these techniques have been coupled with transarticular screw fixation. Significant technical difficulties, however, including the possibility of neurovascular compromise during implantation are associated with transarticular screw placement. A novel technique that uses direct polyaxial screw fixation to C1 and C2 and bilateral longitudinal rods was developed recently. However, there are no published reports detailing the biomechanical characteristics of this new construct. METHODS In this study, 10 fresh-frozen human cadaveric cervical spines with occiput (C0-C4) were used. Osteoligamentous specimens were tested in their intact condition after destabilization via odontoidectomy, and after two different Gallie wiring techniques. Each specimen was assigned to one of the two screw fixation groups. Five specimens were implanted with the polyaxial screw-rod construct and tested. The remaining five specimens were tested after application of bilateral C1-C2 transarticular screws with Gallie wiring (Magerl-Gallie technique). Pure-moment loading, up to 1.5 Nm in flexion and extension, right and left lateral bending and right and left axial rotation, was applied to the occiput, and relative intervertebral rotations were determined using stereophotogrammetry (motion analysis system). Range of motion data for all fixation scenarios were normalized to the destabilized case, and statistical analysis was performed using one-way analysis of variance with Fisher's least significant difference PLSD post hoc test for multiple comparisons. RESULTS The data indicate that destabilization via odontoidectomy significantly increased C1-C2 motion. Both screw techniques significantly decreased motion, as compared with both Gallie wiring methods in lateral bending and axial rotation (P < 0.02 for all) and tended toward reduced motion in flexion-extension. There was no statistically significant difference between the two screw techniques. CONCLUSIONS The results clearly indicate the screw-rod system's equivalence in reducing relative atlantoaxial motion in a severely destabilized upper cervical spine, as compared with the transarticular screw-wiring construct. These findings mirror the previously reported clinical results attained using this new screw-rod construct. Thus, the decision to use either screw construct should be based on safety considerations rather than acute stability.

234 citations

Journal ArticleDOI
TL;DR: In this paper, the authors used nanoindentation to characterize the elastic moduli of soft, elastomeric polydimethylsiloxane (PDMS) samples and determine the effects of adhesion on these measurements using adhesion contact mechanics models.
Abstract: With the potential to map mechanical properties of heterogeneous materials on a micrometer scale, there is growing interest in nanoindentation as a materials characterization technique. However, nanoindentation has been developed primarily for characterization of hard, elasto-plastic materials, and the technique has not been validated for very soft materials with moduli less than 5 MPa. The current study attempted to use nanoindentation to characterize the elastic moduli of soft, elastomeric polydimethylsiloxane (PDMS) samples (with different degrees of crosslinking) and determine the effects of adhesion on these measurements using adhesion contact mechanics models. Results indicate that nanoindentation was able to differentiate between elastic moduli on the order of hundreds of kilo-Pascals. Moreover, calculations using the classical Hertz contact model for dry and aqueous environment gave higher elastic modulus values when compared to those obtained from unconfined compression testing. These data seem to suggest that consideration of the adhesion energy at the tip-sample interface is a significantly important parameter and needs to be taken into account for consistent elastic modulus determination of soft materials by nanoindentation.

216 citations


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Journal ArticleDOI
26 Aug 2020-Nature
TL;DR: The role of viscoelasticity of tissues and extracellular matrices in cell–matrix interactions and mechanotransduction and the potential utility of vis coelastic biomaterials in regenerative medicine are explored.
Abstract: Substantial research over the past two decades has established that extracellular matrix (ECM) elasticity, or stiffness, affects fundamental cellular processes, including spreading, growth, proliferation, migration, differentiation and organoid formation. Linearly elastic polyacrylamide hydrogels and polydimethylsiloxane (PDMS) elastomers coated with ECM proteins are widely used to assess the role of stiffness, and results from such experiments are often assumed to reproduce the effect of the mechanical environment experienced by cells in vivo. However, tissues and ECMs are not linearly elastic materials-they exhibit far more complex mechanical behaviours, including viscoelasticity (a time-dependent response to loading or deformation), as well as mechanical plasticity and nonlinear elasticity. Here we review the complex mechanical behaviours of tissues and ECMs, discuss the effect of ECM viscoelasticity on cells, and describe the potential use of viscoelastic biomaterials in regenerative medicine. Recent work has revealed that matrix viscoelasticity regulates these same fundamental cell processes, and can promote behaviours that are not observed with elastic hydrogels in both two- and three-dimensional culture microenvironments. These findings have provided insights into cell-matrix interactions and how these interactions differentially modulate mechano-sensitive molecular pathways in cells. Moreover, these results suggest design guidelines for the next generation of biomaterials, with the goal of matching tissue and ECM mechanics for in vitro tissue models and applications in regenerative medicine.

776 citations

Journal ArticleDOI
TL;DR: There is a correlation between the degree of difficulty and the anatomy of the oropharynx in the same patient, and any screening test which adds to ability to predict difficulty in intubation must be welcomed, as failure to intubate can potentially lead to fatality.
Abstract: This is a retrospective study of patients whose tracheas were impossible to intubate on a previous occasion. There is a correlation between the degree of difficulty and the anatomy of the oropharynx in the same patient. The study was initially on obstetric patients but was extended to nonobstetric surgical patients in order to increase the number of cases investigated. The incidence of failed intubations in the obstetric group over a 3-year period was seven out of 1980 cases, whereas in the surgical group the results were six out of 13,380 patients. Any screening test which adds to our ability to predict difficulty in intubation must be welcomed, as failure to intubate can potentially lead to fatality.

690 citations

Journal ArticleDOI
TL;DR: OpenSim is an extensible and user-friendly software package built on decades of knowledge about computational modeling and simulation of biomechanical systems that enables computational scientists to create new state-of-the-art software tools and empowers others to use these tools in research and clinical applications.
Abstract: Movement is fundamental to human and animal life, emerging through interaction of complex neural, muscular, and skeletal systems. Study of movement draws from and contributes to diverse fields, including biology, neuroscience, mechanics, and robotics. OpenSim unites methods from these fields to create fast and accurate simulations of movement, enabling two fundamental tasks. First, the software can calculate variables that are difficult to measure experimentally, such as the forces generated by muscles and the stretch and recoil of tendons during movement. Second, OpenSim can predict novel movements from models of motor control, such as kinematic adaptations of human gait during loaded or inclined walking. Changes in musculoskeletal dynamics following surgery or due to human–device interaction can also be simulated; these simulations have played a vital role in several applications, including the design of implantable mechanical devices to improve human grasping in individuals with paralysis. OpenSim is an extensible and user-friendly software package built on decades of knowledge about computational modeling and simulation of biomechanical systems. OpenSim’s design enables computational scientists to create new state-of-the-art software tools and empowers others to use these tools in research and clinical applications. OpenSim supports a large and growing community of biomechanics and rehabilitation researchers, facilitating exchange of models and simulations for reproducing and extending discoveries. Examples, tutorials, documentation, and an active user forum support this community. The OpenSim software is covered by the Apache License 2.0, which permits its use for any purpose including both nonprofit and commercial applications. The source code is freely and anonymously accessible on GitHub, where the community is welcomed to make contributions. Platform-specific installers of OpenSim include a GUI and are available on simtk.org.

642 citations