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J P Albright

Publications and source records attributed to J P Albright.

At least 19 recordsLinked to original sources
PubMed2001

The diagnosis of PCL injury: literature review and introduction of two novel tests.

Isolated PCL injuries have become more prevalent in recent years, possibly as a result of improved awareness and clinical recognition. However, the diagnosis can be difficult, and many of these injuries continue to go undiagnosed. Several clinical tests for PCL laxity have been described over the years, with varying degrees of sensitivity and clinical applicability. These include the posterior drawer, the Muller Quadriceps Active Test, Godfrey's Test, Trillat's reverse lachman/total translation test, and the Dynamic Posterior Shift. All of these tests require significant posterior laxity associated with complete PCL disruption to be positive. Use of the KT-1000 arthrometer, and several radiographic tests have also been developed to help with diagnosis and quantification of laxity. It is the purpose of this paper to review the technique and application of the established diagnostic tests for PCL deficiency, and to introduce two new tests employed by the senior author for nearly three decades. It is the authors' experience that these new tests are sufficiently sensitive to allow the examiner to detect the presence of PCL insufficiency even in the most difficult diagnostic situations with subtle laxity.

Adult↗
PubMed1997

Retropatellar contact stress in simulated patella infera.

Six fresh-frozen cadaver knee joints were used to study changes in retropatellar contact mechanics accompanying patella infera. The knees were tested on a servohydraulic testing machine under conditions simulating stair descent at 10 degrees, 30 degrees, 60 degrees, and 90 degrees of knee flexion. A slotted metallic block mechanism embedded in the region of the tibial tubercle allowed selective distal offset of the patellar tendon insertion so as to model conditions of 0, 6, 13, 19, and 25 mm of patella infera. Patellofemoral and quadriceps tendofemoral contact areas and contact stresses were recorded using Pressensor contact film and quantitated using digital image analysis. Patella infera significantly altered retropatellar contact mechanics. Contact areas migrated proximally on the patella and decreased in size with progressive severity of patella infera. However, the peak and spatial mean retropatellar contact stresses were not elevated correspondingly. Apparently, quadriceps tendofemoral contact was initiated at progressively lower angles of knee flexion as the patella infera progressed. Under conditions of extreme infera at high flexion angles, the magnitude of tendofemoral contact force approached that of retropatellar contact force. These data indicate that in patella infera, patellofemoral contact stresses are not elevated appreciably. Therefore, the disabling symptoms associated with patella infera may be due to factors other than local mechanical overload.

Humans↗
PubMed1996

MRI of complete rupture of the pectoralis major muscle.

Rupture of the pectoralis major muscle is a rare clinical entity. Only few reports have discussed its MRI or CT features. We have reviewed the imaging features of four cases of complete rupture of the pectoralis major muscle. One case of acute injury underwent surgical repair. MRI is useful in delineating the site and extent of the rupture in relation to the musculotendinous junction, which will help the surgeons with possible treatment options and surgical planning. Because of the complex anatomy of the pectoralis major muscle near its insertion on the humerus and the signal characteristics of hematoma and edema in the muscle, axial T2-weighted images were most valuable for the evaluation of acute and subacute injuries. Axial T1-weighted images were helpful in delineating chronic injuries. CT is inferior to MRI for direct visualization of muscle rupture.

Adult↗
PubMed1996

Bilateral osteochondritis dissecans of the elbow in a female pitcher.

We report a case of a 17-year-old female pitcher with bilateral elbow osteochondritis dissecans. Osteochondritis of the elbow is a well-known disorder affecting pitchers and other individuals who sustain repetitive microtrauma to the elbow. Elbow osteochondritis has been described infrequently in female athletes. The incidence and reporting patterns of this disease are likely to increase as more female athletes participate in organized sports.

Adolescent↗
PubMed1995

Use of knee braces in sport. Current recommendations.

This article provides a review of the progress that has been made on the biomechanical, functional performance and epidemiological investigations into the effectiveness of prophylactic knee braces (PKBs) since the position statement against their use was issued in 1987 by the American Academy of Orthopaedics and a review of this subject was last published in Sports Medicine in 1989 by Montgomery and Korziris. The evolution of the salient design features of three surrogate knee models are reviewed along with the results of PKB effectiveness and safety factor testing. While still too limited in scope to be totally realistic, major advances have been made in the sophistication of the present biomechanics laboratory testing conditions. The on-the-field functional performance effects of wearing a knee brace are not always manifest in all individuals. The efficacy of PKBs remains in question but recent studies have taught us enough to put their use into perspective. While they may play some role, PKBs probably represent the least important factor in influencing the likelihood that a medial collateral ligament (MCL) sprain will occur. On the other hand, there is no evidence that such braces put added valgus pressure on some knees, or that wearing a brace is associated with an increased frequency or severity of knee or ankle injury. All else being equal, from the biomechanical studies, we know that whilst some braces are better than others, currently available PKBs can provide 20 to 30% greater resistance to a lateral blow, with the possibility that the anterior cruciate ligament (ACL) is given even greater protection than the MCL. This appears to be true when the lateral blow is of sufficient magnitude to cause significant medial joint line opening, but is not as great at the very lowest levels of impact. Regardless of the material they are made of, the most effective PKBs are those sufficiently stiff to prevent an external blow at the joint line from causing brace hinge contact with the knee tissues. Based on the superior results of the custom-fit functional braces, the most important future design feature appears to be the sizing and fitting of the thigh and tibial cuffs. On the negative side, the presence of a brace may slow an athlete's straight-ahead sprint speed and cause early fatigue to its wearer. This effect appears to vary from one brace to another according to its weight, design features, and pressure from the leg and thigh straps. However, it appears that knee braces do have the potential to restrict performance of the athlete for high-speed running but the effect is related to several factors. The weight of the brace resultant friction of the hinges, completeness of fit, and tightness of straps appear to be important. The most measurable effects include: increased muscular relaxation pressures; increased energy expenditure; and a related increase in blood lactate levels, maximal torque output, oxygen consumption and heart rate. On the other hand, experienced brace wearers and larger, stronger individuals displayed fewer, or no effects of donning a brace. Improvements in the protectiveness of the PKB are likely to accompany improvements in the ability to contour the braces to fit each individual's leg in the equipment room without the added expense of the cast-moulding process. Further improvement may be realised by friction-free polycentric joints, as well as an attachment system that minimises thigh and calf soft tissue compression perhaps by incorporating the braces into the trousers of the uniform to provide suspension from the waist.

Anterior Cruciate Ligament Injuries↗
PubMed1994

Sports fractures.

Fractures occur in athletes and dramatically influence performance during competitive and recreational activities. Fractures occur in athletes as the result of repetitive stress, acute sports-related trauma and trauma outside of athletics. The literature provides general guidelines for treatment as well as a variety of statistics on the epidemiology of fractures by sport and level of participation. Athletes are healthy and motivated patients, and have high expectations regarding their level of function. These qualities make them good surgical candidates. Although closed treatment methods are appropriate for most sports fractures, an aggressive approach to more complicated fractures employing current techniques may optimize their subsequent performance.

Adolescent↗
PubMed1994

Urinary incontinence in elite nulliparous athletes.

OBJECTIVE: To determine the prevalence of the symptom of urinary incontinence during athletic endeavors among a group of nulliparous, elite college varsity female athletes. METHODS: All women currently participating in varsity athletics at a large state university were asked to fill out a questionnaire about the occurrence of urinary incontinence while participating in their sport and during activities of daily life. One hundred forty-four of 156 eligible women (92%) responded. RESULTS: The mean age was 19.9 years, and all women were nulliparous. Overall, 40 athletes (28%) reported urine loss while participating in their sport. The proportions in different sports were: gymnastics 67%, basketball 66%, tennis 50%, field hockey 42%, track 29%, swimming 10%, volleyball 9%, softball 6%, and golf 0%. Two-thirds of the women who noted urine loss during athletics were incontinent more often than rarely. There were no statistically significant relations between incontinence and amenorrhea, weight, hormonal therapy, or duration of athletic activity. Activities most likely to provoke incontinence included jumping, high-impact landings, and running. Forty percent and 17% of the women first noted incontinence during their sport while in high school and junior high school, respectively. CONCLUSIONS: Incontinence during physical stresses is common in young, highly fit, nulliparous women. This suggests that there is a continence threshold which, when exceeded, can result in urine loss, even in the absence of known risk factors for incontinence.

Adolescent↗
PubMed1993

Stress fractures of the foot and leg.

Stress fractures are overuse injuries of bone. Basketball players are particularly prone to develop the notoriously "troublesome" stress fractures of the foot and leg. This article reviews the pathogenesis, epidemiology, diagnosis, and treatment of stress fractures, with specific emphasis on the care of the basketball athlete.

Basketball↗
PubMed1992

Meniscectomy in children and adolescents. A long-term follow-up study.

Thirty-nine patients treated with total meniscectomy younger than 16 years of age were studied. The average follow-up period was 21 years; 71% of the patients reported pain; 68%, stiffness; 54%, swelling; and 41%, giving way. Approximately half the patients described progression of symptoms, but only 27% were asymptomatic. Only 10% noted limitations at work, but 62% had limitations in sports. Twelve percent have had further knee surgery. Forty-nine percent received unsatisfactory subjective/functional ratings. On physical examination, 25% of patients had range of motion loss of greater than 5 degrees, 22% had thigh atrophy of greater than 1 cm, and 20% developed substantial instability. Overall, 27% received unsatisfactory objective ratings. Ninety percent of patients had abnormal roentgenograms. Changes occurred predominantly in the meniscectomized compartment. Forty-four percent of patients had unsatisfactory roentgenographic ratings. Overall ratings indicated that 63% of patients' results rated unsatisfactory. More unsatisfactory results occurred in patients with a follow-up period of longer than 26 years, in those with substantial instability, and in males. Few differences existed between medial and lateral meniscectomies or with increasing durations of symptoms preoperatively.

Adolescent↗
PubMed1988

Patellofemoral joint motion: evaluation by ultrafast computed tomography.

Patellofemoral maltracking is a recognized cause of peripatellar pain. Measurements of the patellofemoral relationships during active motion are not available, and clinicians currently rely on observation, palpation, and static radiographic images to evaluate the symptomatic patient. Ultrafast computed tomography (ultrafast CT) offers objective observations of the dynamic influences of muscle contraction on the patellofemoral joint as the knee is actively moved through a range of motion from 90 degrees flexion to full extension. This study reports our initial observations and establishes a range of normal values so that patients with a clinical suspicion of patellar maltracking may be evaluated.

Adult↗
PubMed1988

Distribution and deposition of tritiated cortisol using phonophoresis.

Tritiated cortisol cream was coupled with light-microscopic autoradiography to histologically trace the distribution and deposition of a topical application of cortisol driven in by a therapeutic dose of ultrasound. Fifteen dogs were divided into four distinct groups: Group 1 consisted of two control dogs; Group 2, four dogs that received 10% radioactive cortisol and no ultrasound; Group 3, four dogs that received 5% radioactive cortisol plus ultrasound; and Group 4, five dogs that received 10% radioactive cortisol plus ultrasound. Although the cortisol applied to all dogs was limited to the epidermis, penetration occurred beyond the stratum corneum. The combination of 10% cortisol and ultrasound showed more penetration than 10% cortisol alone (p = .018), suggesting that ultrasound may be useful in the transdermal delivery of cortisol cream. The difference between the penetration of 5% and 10% cortisol when treated with ultrasound was only marginally significant (p = .062).

Administration, Topical↗
PubMed1988

Injuries in women's gymnastics. The state of the art.

This article takes a three-stage approach to the topic of injuries in women's gymnastics. In the first stage, we review the literature and summarize our current knowledge of injury rates, injuries in specific events, and anatomical location of injuries. In the second, we critically evaluate the relative contributions of these studies in terms of their generalizability, methods, and conceptual approaches. Finally, we present possible directions for future research in the area of women's gymnastic injuries.

Adolescent↗