Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Prineville OR

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Kathleen R Moore, MD
(541) 388-2333
2300 SW Glacier Pl
Redmond, OR
Specialties
Orthopedics
Gender
Female
Education
Medical School: Or Hlth Sci Univ Sch Of Med, Portland Or 97201
Graduation Year: 1989

Data Provided By:
James Roy Karmy, MD
(541) 923-0728
333 NW Larch Ave
Redmond, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Loma Linda Univ Sch Of Med, Loma Linda Ca 92350
Graduation Year: 1973
Hospital
Hospital: Mountain View Hospital Dist, Madras, Or; Central Oregon District Hosp, Redmond, Or
Group Practice: Redmond Orthopedic Clinic

Data Provided By:
Scot E Burgess, DMD
(541) 923-7432
PO Box 697 710 SW Highland Ave
Redmond, OR
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Masatoshi Yamanaka
(503) 361-5400
5125 Skyline Rd S
Salem, OR
Specialty
Orthopedic Surgery

Data Provided By:
Hans Stern Moller III, MD
(971) 645-8429
11482 SW Barnes Rd #300 Bldg C
Portland, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Ohio, Toledo Oh 43699
Graduation Year: 1977

Data Provided By:
Dr.Brett Gingold
(541) 388-2333
1315 Northwest 4th Street
Redmond, OR
Gender
M
Education
Medical School: Univ Of Vt Coll Of Med
Year of Graduation: 1997
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 3, reviews.

Data Provided By:
Richard Henry Bolt, MD
(541) 923-4382
3310 NW Tetherow Bridge Loop
Redmond, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Il Coll Of Med, Chicago Il 60680
Graduation Year: 1970
Hospital
Hospital: Memorial Hospital At Oconomowo, Oconomowoc, Wi; Waukesha Memorial Hospital, Waukesha, Wi
Group Practice: Orthopaedic Assoc-Waukesha

Data Provided By:
Ronald G Worland
(541) 773-2110
2959 Siskiyou Blvd
Medford, OR
Specialty
Hand Surgery

Data Provided By:
Timothy Richard Borman
(503) 375-3636
700 Bellevue St Se
Salem, OR
Specialty
Orthopaedic Surgery of the Spine

Data Provided By:
Jeffreys David Albright, MD
(503) 661-5388
24076 SE Stark St Ste 110
Gresham, OR
Specialties
Orthopedics
Gender
Male
Education
Medical School: Dartmouth Med, Hanover Nh 03755
Graduation Year: 1992

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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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