John Bucchieri | Columbia University (original) (raw)
Papers by John Bucchieri
Orthopedic Clinics of North America, 1997
Thorough understanding of rotator cuff mechanics is important for effective treatment and/or prev... more Thorough understanding of rotator cuff mechanics is important for effective treatment and/or prevention of cuff injuries. This understanding is achieved through knowledge of normal cuff structure and mechanics. Only then, can the effects of injuries and pathologic processes on normal cuff function be carefuly assessed. Rotator cuff structures are viewed and analyzed on a number of different levels. This article presents current knowledge of rotator cuff mechanics through review of cuff structure and anatomy, corocoacromial arch structure and biomechanics, and biomechanical models.
Journal of Shoulder and Elbow Surgery, 2000
The mechanical response of the inferior glenohumeral ligament to varying subfailure cyclic strain... more The mechanical response of the inferior glenohumeral ligament to varying subfailure cyclic strains was studied in 33 fresh frozen human cadaver shoulders. The specimens were tested as bone-ligament-bone preparations representing the 3 regions of the inferior glenohumeral ligament (superior band and anterior and posterior axillary pouches) through use of uniaxial tensile cycles. After mechanical preconditioning, each specimen was subjected to 7 test segments, consisting of a baseline strain level L1 (400 cycles) alternating with either 1 (group A, 10 shoulders), 10 (group B, 13 shoulders), or 100 (group C, 10 shoulders) cycles at increasing levels (L2, L3, L4) of subfailure strain. Cycling to higher levels of subfailure strain (L2, L3, L4) produced dramatic declines in the peak load response of the inferior glenohumeral ligament for all specimens. The group of ligaments subjected to 100 cycles of higher subfailure strains demonstrated a significantly greater decrease in load response than the other 2 groups. Ligament elongation occurred with cyclic testing at subfailure strains for all 3 groups, averaging 4.6% +/- 2.0% for group A, 6.5% +/- 2.6% for group B, and 7.1% +/- 3.2% for group C. Recovery of length after an additional time of nearly 1 hour was minimal. The results from this study demonstrate that repetitive loading of the inferior glenohumeral ligament induces laxity in the ligament, as manifested in the peak load response and measured elongations. The mechanical response of the ligament is affected by both the magnitude of the cyclic strain and the frequency of loading at the higher strain levels. The residual length increase was observed in all of the specimens and appeared to be largely unrecoverable. This length increase may result from accumulated microdamage within the ligament substance, caused by the repetitively applied subfailure strains. The clinical relevance of the study is that this mechanism may contribute to the development of acquired glenohumeral instability, which is commonly seen in the shoulders of young athletes who participate in repetitive overhead sports activities.
Journal of Shoulder and Elbow Surgery, 2000
The purposes of this study were to evaluate the usefulness of thin-section 3-dimensional Fourier ... more The purposes of this study were to evaluate the usefulness of thin-section 3-dimensional Fourier Transform (3DFT) gradient echo imaging of the medial collateral ligament and to evaluate the usefulness of intraarticular gadolinium for the detection of tears of the ligament. Magnetic resonance imaging was performed on 5 fresh-frozen cadaveric elbows through use of T1-weighted and 3DFT gradient echo T2-weighted sequences. The elbows were then arthroscoped, and lesions were created in the medial collateral ligaments. Magnetic resonance imaging was then repeated with the T1 and 3DFT sequences. In addition, dilute gadolinium was then injected intra-articularly, and fat-suppressed T1-weighted images and 3DFT images were obtained. Magnetic resonance imaging findings were correlated with the appearance of the dissected ligament. We found that in the prearthroscopy specimens, the ligament was best seen on the 3DFT images reformatted into a slightly posteriorly obliqued coronal plane. In the post-arthroscopy elbows, 4 full-thickness perforations were detected with the 3DFT sequence; fat-suppressed T1-weighted images with intraarticular gadolinium detected these 4 as well as 1 partial inner surface tear. In conclusion, fat-suppressed T1-weighted magnetic resonance arthrography with gadolinium can provide information regarding inner surface partial tears and small full-thickness perforations.
Journal of Orthopaedic Research, 2005
Disorders of the rotator cuff, particularly tears of the rotator cuff tendons, cause significant ... more Disorders of the rotator cuff, particularly tears of the rotator cuff tendons, cause significant shoulder disability. Among numerous factors thought to be responsible for the initiation and progression of supraspinatus tears are those related to the tendon's biomechanical properties. We hypothesized that in supraspinatus tendons subjected to tensile loading a strain gradient (difference) exists between the articular and bursal tendon surfaces, that regional strain differences exist on each of these two tendon surfaces, and that tendon surface strains vary with glenohumeral abduction. To test these hypotheses, the intrinsic inhomogeneous deformational characteristics of the articular and bursal surfaces of eight intact human cadaveric supraspinatus tendons were studied at three glenohumeral abduction angles using a novel multiple strain measuring system which simultaneously recorded surface marker displacements on two opposing soft tissue surfaces. Under applied tensile loads, the articular surface exhibited greater strain at 22" (7.4 k 2.6% vs. 1.3 f 0.7%, p = 0.0002) and 63" (6.4 f 1.6% vs. 2.7 k 1.2%, p = 0.0001) whereas the bursal surface exhibited greater strain at 90" (7.6 f 2.8% vs. 4.9 f 0.4%, p = 0.013). At all abduction angles, insertion strains were higher than those of the mid-tendon and tendon-muscle junction regions. The existence of inhomogeneous surface strains in the intact supraspinatus tendon demonstrates that intratendinous shear occurs within the tendon. The higher strain on the articular side of the tendon, especially at the insertion region, suggests a propensity for tears to initiate in the articular tendinous zone.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 1993
Orthopedic Clinics of North America, 1997
Thorough understanding of rotator cuff mechanics is important for effective treatment and/or prev... more Thorough understanding of rotator cuff mechanics is important for effective treatment and/or prevention of cuff injuries. This understanding is achieved through knowledge of normal cuff structure and mechanics. Only then, can the effects of injuries and pathologic processes on normal cuff function be carefuly assessed. Rotator cuff structures are viewed and analyzed on a number of different levels. This article presents current knowledge of rotator cuff mechanics through review of cuff structure and anatomy, corocoacromial arch structure and biomechanics, and biomechanical models.
Journal of Shoulder and Elbow Surgery, 2000
The mechanical response of the inferior glenohumeral ligament to varying subfailure cyclic strain... more The mechanical response of the inferior glenohumeral ligament to varying subfailure cyclic strains was studied in 33 fresh frozen human cadaver shoulders. The specimens were tested as bone-ligament-bone preparations representing the 3 regions of the inferior glenohumeral ligament (superior band and anterior and posterior axillary pouches) through use of uniaxial tensile cycles. After mechanical preconditioning, each specimen was subjected to 7 test segments, consisting of a baseline strain level L1 (400 cycles) alternating with either 1 (group A, 10 shoulders), 10 (group B, 13 shoulders), or 100 (group C, 10 shoulders) cycles at increasing levels (L2, L3, L4) of subfailure strain. Cycling to higher levels of subfailure strain (L2, L3, L4) produced dramatic declines in the peak load response of the inferior glenohumeral ligament for all specimens. The group of ligaments subjected to 100 cycles of higher subfailure strains demonstrated a significantly greater decrease in load response than the other 2 groups. Ligament elongation occurred with cyclic testing at subfailure strains for all 3 groups, averaging 4.6% +/- 2.0% for group A, 6.5% +/- 2.6% for group B, and 7.1% +/- 3.2% for group C. Recovery of length after an additional time of nearly 1 hour was minimal. The results from this study demonstrate that repetitive loading of the inferior glenohumeral ligament induces laxity in the ligament, as manifested in the peak load response and measured elongations. The mechanical response of the ligament is affected by both the magnitude of the cyclic strain and the frequency of loading at the higher strain levels. The residual length increase was observed in all of the specimens and appeared to be largely unrecoverable. This length increase may result from accumulated microdamage within the ligament substance, caused by the repetitively applied subfailure strains. The clinical relevance of the study is that this mechanism may contribute to the development of acquired glenohumeral instability, which is commonly seen in the shoulders of young athletes who participate in repetitive overhead sports activities.
Journal of Shoulder and Elbow Surgery, 2000
The purposes of this study were to evaluate the usefulness of thin-section 3-dimensional Fourier ... more The purposes of this study were to evaluate the usefulness of thin-section 3-dimensional Fourier Transform (3DFT) gradient echo imaging of the medial collateral ligament and to evaluate the usefulness of intraarticular gadolinium for the detection of tears of the ligament. Magnetic resonance imaging was performed on 5 fresh-frozen cadaveric elbows through use of T1-weighted and 3DFT gradient echo T2-weighted sequences. The elbows were then arthroscoped, and lesions were created in the medial collateral ligaments. Magnetic resonance imaging was then repeated with the T1 and 3DFT sequences. In addition, dilute gadolinium was then injected intra-articularly, and fat-suppressed T1-weighted images and 3DFT images were obtained. Magnetic resonance imaging findings were correlated with the appearance of the dissected ligament. We found that in the prearthroscopy specimens, the ligament was best seen on the 3DFT images reformatted into a slightly posteriorly obliqued coronal plane. In the post-arthroscopy elbows, 4 full-thickness perforations were detected with the 3DFT sequence; fat-suppressed T1-weighted images with intraarticular gadolinium detected these 4 as well as 1 partial inner surface tear. In conclusion, fat-suppressed T1-weighted magnetic resonance arthrography with gadolinium can provide information regarding inner surface partial tears and small full-thickness perforations.
Journal of Orthopaedic Research, 2005
Disorders of the rotator cuff, particularly tears of the rotator cuff tendons, cause significant ... more Disorders of the rotator cuff, particularly tears of the rotator cuff tendons, cause significant shoulder disability. Among numerous factors thought to be responsible for the initiation and progression of supraspinatus tears are those related to the tendon's biomechanical properties. We hypothesized that in supraspinatus tendons subjected to tensile loading a strain gradient (difference) exists between the articular and bursal tendon surfaces, that regional strain differences exist on each of these two tendon surfaces, and that tendon surface strains vary with glenohumeral abduction. To test these hypotheses, the intrinsic inhomogeneous deformational characteristics of the articular and bursal surfaces of eight intact human cadaveric supraspinatus tendons were studied at three glenohumeral abduction angles using a novel multiple strain measuring system which simultaneously recorded surface marker displacements on two opposing soft tissue surfaces. Under applied tensile loads, the articular surface exhibited greater strain at 22" (7.4 k 2.6% vs. 1.3 f 0.7%, p = 0.0002) and 63" (6.4 f 1.6% vs. 2.7 k 1.2%, p = 0.0001) whereas the bursal surface exhibited greater strain at 90" (7.6 f 2.8% vs. 4.9 f 0.4%, p = 0.013). At all abduction angles, insertion strains were higher than those of the mid-tendon and tendon-muscle junction regions. The existence of inhomogeneous surface strains in the intact supraspinatus tendon demonstrates that intratendinous shear occurs within the tendon. The higher strain on the articular side of the tendon, especially at the insertion region, suggests a propensity for tears to initiate in the articular tendinous zone.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 1993