Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Derby KS

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Kenneth Jansson
(316) 631-1600
2778 N Webb Rd
Wichita, KS
Business
Advanced Orthopaedics Associates
Specialties
Orthopedics, Sports Medicine, Arthroscopic Surgery
Insurance
Insurance Plans Accepted: Almost all insurance plans accepted.
Medicare Accepted: Yes
Workmens Comp Accepted: Yes
Accepts Uninsured Patients: Yes

Doctor Information
Primary Hospital: Kansas Surgery and Recovery Center; Surgicare of Wichita
Residency Training: Wilford Hall USAF Medical Center, Lackland AFB, TX
Medical School: Darthmouth, 1982
Additional Information
Member Organizations: American College of Sports Medicine American Medical Association American Medical Society for Sports Medicine American Orthopaedic Society for Sports Medicine Arthroscopy Association of North America Fellow American Academy of Orthopaedic Surgeo


Data Provided By:
Christopher Robert Brown, MD
(316) 685-1040
9415 E Harry St Ste 605
Wichita, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Va Commonwealth Univ, Med Coll Of Va Sch Of Med, Richmond Va 23298
Graduation Year: 2000

Data Provided By:
Dr.Robert Eyster
(316) 858-1600
1131 S Clifton Ave # A
Wichita, KS
Gender
M
Education
Medical School: Univ Of Ok Coll Of Med
Year of Graduation: 1973
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
2.5, out of 5 based on 3, reviews.

Data Provided By:
Bradford Alan Wall, MD
Wichita, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Ga Sch Of Med, Augusta Ga 30912
Graduation Year: 2003

Data Provided By:
Jay Stanley Jones, MD
(316) 684-8211
1515 S Clifton Ave Ste 130
Wichita, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Auto De Guadalajara, Fac De Med, Guadalajara, Jalisco, Mexico
Graduation Year: 1977

Data Provided By:
Wendell J Mettman, DDS
(316) 788-3736
PO Box 207
Derby, KS
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Robert Lamar Eyster
(316) 858-1600
1131 S Clifton Ave
Wichita, KS
Specialty
Orthopedic Surgery

Data Provided By:
Mark L Morishige, MD
Wichita, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Chicago, Pritzker Sch Of Med, Chicago Il 60637
Graduation Year: 2003

Data Provided By:
Jay Stanley Jones
(316) 684-8211
1515 S Clifton Ave
Wichita, KS
Specialty
Orthopedic Surgery

Data Provided By:
Robert Lamar Eyster, MD
(316) 631-1699
1131 S Clifton Ave
Wichita, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduation Year: 1973

Data Provided By:
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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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