Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Las Vegas NV

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G. Michael Elkanich, M.D.
(702) 474-7200
2020 Palomino Lane
Las Vegas, NV
Business
Bone & Joint Specialists
Specialties
Orthopedics, Degenerative Spinal Conditions
Cervical, Thoracic, and Lumbar Fusion
Cervical, Thoracic, and Lumbar Diskectomy
Cervical, Thoracic, and Lumbar Decompression
Total Disk Replacement - Cervical & Lumbar
Endoscopic Spinal Fusion
M
Insurance
Medicare Accepted: Yes
Workmens Comp Accepted: Yes
Accepts Uninsured Patients: Yes
Emergency Care: Yes

Doctor Information
Primary Hospital: Valley Medical Center
Residency Training: Stanford University Hosptial & Clinics
Medical School: University Of Arizona College of Medicine, 1997
Additional Information
Member Organizations: North American Spine Society
American Academy of Orthopaedic Surgeons
American Medical Association
State Medical Society
State Orthopaedic Society

Awards: American Board of Orthopaedic Surgeons - Board Certified
Languages Spoken: English,Spanish,Chinese

Data Provided By:
Kayvan Taghipour-Khiabani
(702) 671-5110
1707 W Charleston Blvd
Las Vegas, NV
Specialty
Hand Surgery

Data Provided By:
Gerald Mark Sylvain, MD
(702) 388-1008
3100 W Charleston Blvd
Las Vegas, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Nv Sch Of Med, Reno Nv 89557
Graduation Year: 1991

Data Provided By:
Himansu R Shah
(702) 671-5110
1707 W Charleston Blvd
Las Vegas, NV
Specialty
Hand Surgery

Data Provided By:
Ascar Eghtedar, MD
(702) 878-9444
2601 W Charleston Blvd
Las Vegas, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Teheran Univ, Fac Of Med, Teheran, Iran
Graduation Year: 1959

Data Provided By:
Archie C Perry, MD
(701) 731-1616
2800 E Desert Inn Rd
Las Vegas, NV
Business
Desert Orthopaedic Center
Specialties
Orthopedics

Data Provided By:
Mark Jesse Saylor, DDS
(702) 870-1350
1350 S Decatur Blvd
Las Vegas, NV
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Chester W Eskey, MD
(702) 731-1616
1650 Waldman Ave
Las Vegas, NV
Specialties
Orthopedics
Gender
Male
Education
Graduation Year: 2007

Data Provided By:
Michael Young Han, MD
2450 W Charleston Blvd
Las Vegas, NV
Specialties
Orthopedics
Gender
Male
Education
Medical School: Stanford Univ Sch Of Med, Stanford Ca 94305
Graduation Year: 1999

Data Provided By:
Chester W Eskey, MD FACS
(702) 387-7807
1650 Waldman Ave
Las Vegas, NV
Gender
Male
Education
Medical School: Jefferson
Graduation Year: 1949

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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