Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Dodge City KS

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Alok Shah
(620) 227-1371
2020 Central Ave
Dodge City, KS
Specialty
Orthopedic Surgery

Data Provided By:
Alexander Baxter Neel, MD
(620) 225-7744
2300 N 14th Ave Ste 104
Dodge City, KS
Specialties
Orthopedics, General Surgery
Gender
Male
Education
Medical School: Univ Of Rochester Sch Of Med & Dentistry, Rochester Ny 14642
Graduation Year: 1982
Hospital
Hospital: Pratt Reg Med Ctr, Pratt, Ks; Western Plains Reg Hosp, Dodge City, Ks
Group Practice: Orthopedics & Sports Medicine

Data Provided By:
Vello Kass
(316) 284-5160
720 Medical Center Dr
Newton, KS
Specialty
Orthopedic Surgery

Data Provided By:
John B Moore
(913) 782-0707
20375 W 151st St
Olathe, KS
Specialty
Hand Surgery

Data Provided By:
Michael James Baughman, MD
(620) 275-8400
101 E Fulton St
Garden City, KS
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ks Sch Of Med, Kansas City Ks 66103
Graduation Year: 1982
Hospital
Hospital: St Catherine Hosp, Garden City, Ks
Group Practice: Sandhill Orthopaedic & Sports

Data Provided By:
Richard J Ackerman, DDS
(620) 227-2234
705 1st Ave Ste B
Dodge City, KS
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
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:
Douglas C Burton, MD
(913) 588-7568
3901 Rainbow Blvd MS Ste 3017,
Kansas City, KS
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Thomas S Samuelson
(913) 381-5225
10701 Nall Ave
Overland Park, KS
Specialty
Orthopedic Surgery

Data Provided By:
William W Bohn
(913) 782-1148
20920 W 151st St
Olathe, KS
Specialty
Orthopedic Surgery

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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