Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Flagstaff AZ

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Roman T. Lewicky, MD
(928) 774-7757
1485 N. Tourquoise Dr.
Flagstaff, AZ
Business
Northern Arizona Orthopaedics, LTD.
Specialties
Orthopedics
Insurance
Insurance Plans Accepted: Blue CrossUnited Healthcare
Medicare Accepted: Yes
Workmens Comp Accepted: Yes
Accepts Uninsured Patients: Yes
Emergency Care: No

Doctor Information
Primary Hospital: Flagstaff Medical Center
Residency Training: Northwestern University Medical Center Orthopaedic Surgery 1975
Medical School: Northwestern University Medical School, 1968
Additional Information
Member Organizations: ABOS AAOS AANA ArMA
Awards: Arizona Sports Medicine Doctor of the Year, 1982.
Languages Spoken: English,Spanish,Ukrainian,Polish

Data Provided By:
Bert McKinnon
(928) 773-2538
77 W Forest Ave
Flagstaff, AZ
Specialty
Orthopedic Surgery

Data Provided By:
Michael Abeshaus, MD
(928) 774-7757
1485 N Turquoise Dr Ste 200
Flagstaff, AZ
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Az Coll Of Med, Tucson Az 85724
Graduation Year: 1986

Data Provided By:
Robert T Caskey, DDS
(928) 774-2745
710 N Beaver St Ste 4B
Flagstaff, AZ
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Francis Xavier Maher, MD
(928) 773-2535
77 W Forest Ave Ste 301
Flagstaff, AZ
Specialties
Orthopedics
Gender
Male
Education
Medical School: Northwestern Univ Med Sch, Chicago Il 60611
Graduation Year: 1970

Data Provided By:
Paul Kingsley Forberg, MD
(928) 527-0904
Flagstaff, AZ
Specialties
Orthopedics
Gender
Male
Education
Medical School: Tufts Univ Sch Of Med, Boston Ma 02111
Graduation Year: 1967

Data Provided By:
Yuri M. Lewicky, MD
(928) 774-7757
1485 N. Turquoise Drive 
Flagstaff, AZ
Specialty
Orthopaedic Sugeon
Gender
Sports Medicine Doctor, shoulder, knee injuries

Data Provided By:
Dr.Donald Hales
(928) 774-7757
1485 N Turquoise Dr # 130
Flagstaff, AZ
Gender
M
Education
Medical School: Johns Hopkins Univ Sch Of Med
Year of Graduation: 1982
Speciality
Orthopedic Surgeon
General Information
Hospital: Flagstaff Reigional
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

Data Provided By:
Joel Thomas Rohrbough, MD
(928) 774-7757
77 W Forest Ave Ste 302
Flagstaff, AZ
Specialties
Orthopedics
Gender
Male
Education
Medical School: Loma Linda Univ Sch Of Med, Loma Linda Ca 92350
Graduation Year: 1992

Data Provided By:
Darius Mirza Moezzi
(928) 773-2280
77 W Forest Ave
Flagstaff, AZ
Specialty
Orthopedic Surgery

Data Provided By:
Data Provided By:

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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