Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Dickson TN

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Jan M Gorzny, MD
(615) 441-4574
113 Highway 70 E
Dickson, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Suny At Buffalo Sch Of Med & Biomedical Sci, Buffalo Ny 14214
Graduation Year: 1974

Data Provided By:
James L Rushford
(615) 446-2708
758 Highway 46 South
Dickson, TN
Specialty
Orthopedic Surgery

Data Provided By:
D Marshall Jemison, MD
(423) 756-7134
979 E 3rd St
Chattanooga, TN
Business
The Plastic Surgery Group PC
Specialties
Orthopedics

Data Provided By:
Thomas F Parrish, MD FACS
301 21st Ave N
Nashville, TN
Gender
Male
Education
Medical School: Vanderbilt
Graduation Year: 1948

Data Provided By:
Lawrence Brett Babat, MD
(615) 860-1580
3443 Dickerson Pike Ste 190
Nashville, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Yale Univ Sch Of Med, New Haven Ct 06510
Graduation Year: 1995

Data Provided By:
Ronald Gerard Derr, DO
(615) 790-3290
115 Highway 70 E
Dickson, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Ohio Univ, Coll Of Osteo Med, Athens Oh 45701
Graduation Year: 1988

Data Provided By:
Dr. Chad Upchurch
Life Source Wellness Center
(615) 441-6115
491 Henslee Dr
Dickson, TN
Specialty
Chiropractor
Conditions
Back pain,Chronic pain,Leg pain,Lower back pain,Neck pain,Upper back pain
Treatments
Chiropractic adjustment,Chiropractic care,Spinal manipulation
Proffesional Affiliation
Tennessee Chiropractic Association

James Byron Talmage
(931) 526-1604
315 N Washington Ave
Cookeville, TN
Specialty
Orthopedic Surgery

Data Provided By:
Dr.Rickey Parsons
(865) 690-4861
9430 Park West Boulevard #320
Knoxville, TN
Gender
M
Education
Medical School: East Carolina Univ Sch Of Med
Year of Graduation: 1989
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 2, reviews.

Data Provided By:
Dr.PAUL NAYLOR
(865) 690-4861
9430 Park West Blvd # 130
Knoxville, TN
Gender
M
Education
Medical School: Univ Of Tn, Memphis, Coll Of Med
Year of Graduation: 1985
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
1.0, out of 5 based on 1, reviews.

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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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