Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Hastings MN

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Jerome Perra
(651) 842-5412
1285 Nininger Rd
Hastings, MN
Specialty
Orthopedic Surgery

Data Provided By:
Mary L Sedivy, DDS
(651) 459-6674
7729 79th St S
Cottage Grove, MN
Specialties
Orthodontics/Dentofacial Orthopedics

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Regina Lynn Blevins, DDS
(651) 450-7273
5965 Carmen Ave
Inver Grove Heights, MN
Specialties
Orthodontics/Dentofacial Orthopedics

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Paul B Gersmeyer, DDS
(507) 334-6433
331 Faribault Rd
Rosemount, MN
Specialties
Orthodontics/Dentofacial Orthopedics

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Steven J Henseler, DDS
(651) 739-1555
1000 Radio Dr Ste 220
Saint Paul, MN
Specialties
Orthodontics/Dentofacial Orthopedics

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Jerome John Perra, MD
(651) 842-5412
Hastings, MN
Specialties
Orthopedics, General Surgery
Gender
Male
Education
Medical School: Univ Of Mn Med Sch-Minneapolis, Minneapolis Mn 55455
Graduation Year: 1985
Hospital
Hospital: Dickinson County Mem Hosp, Spirit Lake, Ia
Group Practice: Iowa Lakes Orthpedic

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Gregg G Hipple, DDS
(651) 459-6674
7729 79th St S
Cottage Grove, MN
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Curtis R Dunn, DDS
(651) 450-7273
5965 Carmen Ave
Inver Grove Heights, MN
Specialties
Orthodontics/Dentofacial Orthopedics

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Jon Craig Paulson, MD
(651) 439-8807
10245 Fox Run Rd
Saint Paul, MN
Specialties
Orthopedics, Hand Surgery
Gender
Male
Education
Medical School: Univ Of Mn Med Sch-Minneapolis, Minneapolis Mn 55455
Graduation Year: 1974

Data Provided By:
Robert E Eng, DDS
(651) 645-5213
1630 University Ave W
Inver Grove Heights, MN
Specialties
Orthodontics/Dentofacial Orthopedics

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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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