Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Cody WY

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John Alfred Bluher, DDS
(307) 864-2336
1120 Beck Ave
Cody, WY
Specialties
Orthodontics/Dentofacial Orthopedics

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Jay Albert Winzenried, MD
(719) 333-5040
726 Allen Ave
Cody, WY
Specialties
Orthopedics, General Surgery
Gender
Male
Education
Medical School: Univ Of Tx Med Sch At San Antonio, San Antonio Tx 78284
Graduation Year: 1985
Hospital
Hospital: Powell Hospital, Powell, Wy

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Dr.Frank Schmidt
(307) 578-1955
720 Lindsay Ln # C
Cody, WY
Gender
M
Education
Medical School: Baylor Coll Of Med
Year of Graduation: 1983
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

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Jay A Winzenried
(307) 527-7100
721 Sheridan Ave Ste 130
Cody, WY
Specialty
Orthopedic Surgery

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Jimmie Gene Biles, MD
(307) 578-1945
720 Lindsay Ln
Cody, WY
Specialties
Orthopedics
Gender
Male
Languages
Spanish
Education
Medical School: U Of Tx Med Sch At Houston, Houston Tx 77225
Graduation Year: 1981
Hospital
Hospital: West Park Hospital, Cody, Wy; Powell Hospital, Powell, Wy
Group Practice: Big Horn Basin Orthopaedic Clinic Pc

Data Provided By:
Frank Hall Schmidt, MD
(307) 578-1960
720 Lindsay Ln
Cody, WY
Specialties
Orthopedics
Gender
Male
Education
Medical School: Baylor Coll Of Med, Houston Tx 77030
Graduation Year: 1983

Data Provided By:
Stephen Foster Emery, MD
(307) 578-1959
720 Lindsay Ln
Cody, WY
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Tx Med Branch Galveston, Galveston Tx 77550
Graduation Year: 1980
Hospital
Hospital: West Park Hospital, Cody, Wy; Powell Hospital, Powell, Wy
Group Practice: Big Horn Basin Orthopaedic Clinic Pc

Data Provided By:
Frank H Schmidt
(307) 578-1955
720 Lindsay Ln
Cody, WY
Specialty
Orthopedic Surgery

Data Provided By:
Dr.Jimmie Biles
(307) 578-1953
720 Lindsay Ln # B
Cody, WY
Gender
M
Education
Medical School: U Of Tx Med Sch At Houston
Year of Graduation: 1981
Speciality
Orthopedic Surgeon
General Information
Hospital: West Park Hospital, Cody, Wy
Accepting New Patients: Yes
RateMD Rating
3.7, out of 5 based on 3, reviews.

Data Provided By:
Richard B Southwell
(307) 745-8851
1909 Vista Dr
Laramie, WY
Specialty
Orthopedic Surgery

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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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