Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Aztec NM

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Michael Anthony Fallon, MD
(505) 368-6981
Farmington, NM
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Orthopedics
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Male
Education
Medical School: Uniformed Services Univ Of The Hlth Sci, Bethesda Md 20814
Graduation Year: 1994

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Robert C Lehmer
(505) 327-1400
2300 E 30th St Bldg D Ste 101
Farmington, NM
Specialty
Orthopedic Surgery

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John Stanley Romine, MD
(505) 327-1389
708 Ocio Pl
Farmington, NM
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Orthopedics
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Male
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Medical School: Northwestern Univ Med Sch, Chicago Il 60611
Graduation Year: 1959
Hospital
Hospital: San Juan Reg Med Ctr, Farmington, Nm

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Dr.Jason Lucas
(505) 326-1400
Bldg D-101, 2300 East 30th Street
Farmington, NM
Gender
M
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Orthopedic Surgeon
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Accepting New Patients: Yes
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4.5, out of 5 based on 1, reviews.

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Robert Charles Lehmer, MD
(505) 327-9658
2300 E 30th St Bldg D-101
Farmington, NM
Specialties
Orthopedics
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Male
Education
Medical School: Univ Of Il Coll Of Med, Chicago Il 60680
Graduation Year: 1965

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Dennis Ray Kloberdanz, MD
(505) 327-1400
4700 Samantha Ln
Farmington, NM
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Co Sch Of Med, Denver Co 80262
Graduation Year: 1983

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Robert L Grossheim
(505) 327-1400
2300 E 30th St Bldg D Ste 101
Farmington, NM
Specialty
Orthopedic Surgery

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David J Herman, DDS
(505) 564-9000
4449 Bella Vista Cir
Farmington, NM
Specialties
Orthodontics/Dentofacial Orthopedics

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Ernest Lee Stromeyer, DDS
(505) 327-4872
2200 E 20th St
Farmington, NM
Specialties
Orthodontics/Dentofacial Orthopedics

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John K Boice, DDS
(505) 327-4884
904 E 20th St Ste A
Farmington, NM
Specialties
Orthodontics/Dentofacial Orthopedics

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Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions

Persistent ankle pain after an ankle sprain could be a sign of a condition called osteochondral lesion of the talus (OLT). The talus is a bone in the ankle between the calcaneus (heel bone) below and the tibia (shin bone) above.

The bottom of the tibia forms a dome over the top of the talus. With OLT, a piece of cartilage from the talus gets pinched by this dome. In more severe cases, a fragment of cartilage breaks off the talus but stays wedged in place. In the worst cases, the fragment is floating free in the joint space.

Other terms used to describe OLT include osteochondritis dissecans, transchondral fracture, talar dome fracture, and flake fracture. The condition is fairly uncommon. It is difficult to diagnose using X-rays, MRIs, or CT scans.

The authors of this study used arthroscopy to diagnose and treat OLT. They graded the condition based on severity as Grade I (mild) through Grade IV (severe). Treatment results were compared to see if outcomes were better for milder forms of the condition. Results showed that arthroscopic grading of OLT does predict final outcome after surgery. This is something that cannot be accomplished with X-rays or other more advanced forms of imaging.

Milder lesions without fragmentation had better results. Patients were more likely to have a good-to-excellent outcome without complications if the cartilage was not torn away. They were not able to compare results based on specific surgery done because there were too many different kinds of operations performed.

For example, some patients had holes drilled in the talus where the fragment had broken off. This procedure is called microfracture. It stimulates new growth of fibrocartilage. Other patients had the loose piece of cartilage removed (excision) with smoothing of the bone where the piece was broken off. And some patients had both excision and drilling.

Almost three-fourths of the group had good-to-excellent results. Most were able to return to all preoperative levels of activity. A few patients had complications such as plantar fasciitis, nerve pain or injury, or pain around the puncture wounds where the arthroscope entered through the skin. These problems all disappeared during the first six months of recovery.

Results of treatment did not appear to be linked with age, gender, or the side affected (right or left ankle). Delays between injury and surgery did not seem to make any difference in the final results. Worker's compensation patients did have poorer results compared with those who were not on worker's comp.

Follow-up was for at least five years. So it was possible to see if the long-term results changed over time. They found that more than one-third of the patients had a deterioration of their good results over time. Deep aching and pain with swelling recurred. Limited motion and instability occurred with degeneration of the joint. The reason(s) for this change was unknown.

The authors were unable to provi...

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