Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Milledgeville GA

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Anne T Sanchez, DMD
(478) 452-7441
1006 Fernwood Dr
Milledgeville, GA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Steven P Niergarth, DO
(478) 451-0040
1201 N Columbia Dr
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Mi State Univ, Coll Of Osteo Med, East Lansing Mi 48824
Graduation Year: 1985

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Pedro Luis Tamayo, MD
(478) 452-8096
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Inst Sup De Cien Med De La Habana, La Habana, Cuba
Graduation Year: 1959

Data Provided By:
John Hopkins Ferguson, DDS
(478) 453-3445
600 N Cobb ST PO Box 850
Milledgeville, GA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
F. daniel Koch, M.D.
(770) 491-3003
2680 Lawrenceville Highway
Decatur, GA
Business
Resurgens Orthopedics
Specialties
Orthopedics, General Orthopaedics, Adult Spine Surgery
Insurance
Insurance Plans Accepted: Accept most insurance plans

Doctor Information
Primary Hospital: Dekalb Medical Center
Residency Training: University of Louisville
Medical School: Duke University,
Additional Information
Member Organizations: Fellow, American Academy of Orthopaedic Surgeons
Languages Spoken: English

Data Provided By:
Mark Lewis Mudano, MD
(478) 451-0200
541 W Montgomery St Ste 1
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Ga Sch Of Med, Augusta Ga 30912
Graduation Year: 1984

Data Provided By:
Clarence Hughes Fossier, MD
(478) 457-0037
PO Box 750
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Il Coll Of Med, Chicago Il 60680
Graduation Year: 1966

Data Provided By:
Akin Omitowoju, MD
2955 N Columbia St
Milledgeville, GA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Lagos, Coll Of Med, Lagos, Nigeria
Graduation Year: 1972

Data Provided By:
Sami O. Khan, M.D.
(770) 491-3003
2680 Lawrencevill Highway
Decatur, GA
Business
Resrugens Orthopaedics
Specialties
Orthopedics, Arthroscopic and Reconstructive Surgery of the Shoulder, Elbow and Knee, Sports Medicine, General Orthopaedics
Insurance
Insurance Plans Accepted: We accept most insurance plans

Doctor Information
Primary Hospital: Emory Eastside Hospital
Residency Training: New York University Hospital fo rJoint Disease
Medical School: Emory University School of Medicine,
Additional Information
Member Organizations: American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, American Orthopaedic Society of Sports Medicine
Awards: Associate Team Physician, New York Mets MLB 2003-2004 Team Physician, Mississippi Valley State Delta Devils 2006-2007 Associate Physician, Alvin Ailey Dance Theater New York, 2004 Author of multiple textbook chapters involving shoulder and elbow injuri
Languages Spoken: English,Spanish

Data Provided By:
Lawrence A. Bircoll, M.D.
(770) 491-3003
2680 Lawrenceville Highway
Decatur, GA
Business
Resurgens Orthopedics
Specialties
Orthopedics
Insurance
Insurance Plans Accepted: We accept most insurance plans

Doctor Information
Primary Hospital: Dekalb Medical Center
Residency Training: Henry Ford Hospital, Detroit, Michigan
Medical School: University of Michigan School of Medicine,
Additional Information
Member Organizations: American Academy of Orthopaedics Medical Association of Georgia Atlanta Orthoapedic Society
Languages Spoken: English

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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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