Arthroscopic Diagnosis and Treatment of Osteochondral Talar Lesions Waupaca WI

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James Henry De Weerd, MD
(715) 345-5100
190 Grand Seasons Dr
Waupaca, WI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Bowman Gray Sch Of Med Of Wake Forest Univ, Winston-Salem Nc 27157
Graduation Year: 1972

Data Provided By:
Kim Harold Lulloff, MD
Waupaca, WI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Med Coll Of Wi, Milwaukee Wi 53226
Graduation Year: 1960

Data Provided By:
Sean P Keane MD
(414) 277-1155
2015 E Newport Ave
Milwaukee, WI
Specialties
Orthopedics

Data Provided By:
William Engber
(608) 263-7540
600 Highland Ave
Madison, WI
Specialty
Orthopedic Surgery

Data Provided By:
Harvey Louis Barash, MD
(608) 252-8457
1 S Park St
Madison, WI
Specialties
Orthopedics
Gender
Male
Education
Medical School: A Einstein Coll Of Med Of Yeshiva Univ, Bronx Ny 10461
Graduation Year: 1965

Data Provided By:
David Michael Henneghan, MD
(715) 342-7950
190 Grand Seasons Dr
Waupaca, WI
Specialties
Orthopedics
Gender
Male
Education
Medical School: Mi State Univ Coll Of Human Med, East Lansing Mi 48824
Graduation Year: 1984
Hospital
Hospital: St Michaels Hospital, Stevens Point, Wi
Group Practice: Ministry Health Care At Rice Medical Center; Rice Medical Center Ministry Health Care

Data Provided By:
Dr. Rodney Lefler
Neuroscience Group of NE Wisconsin
920-725-9373 or toll free 800-201-1194
1305 W. American Drive
Neenah, WI
Specialty
Chiropractor
Conditions
Cervical spine disorders,Degenerative disc disease,Degenerative spinal conditions,Herniated disc / bulging disc,Lumbar spine disorders,Muscle pain / muscle strain,Neck pain,Sciatica / radiculopathy,Scoliosis and deformity,Spinal stenosis,Spondylolisthesis,Sports injuries,Thoracic spine disorders,Whiplash
Treatments
Exercise,McKenzie Method,Musculoskeletal manipulation,Physical therapy,Rehabilitation,Sports medicine,Strength and Conditioning
Proffesional Affiliation
Wisconsin Chiropractic Association,National Strength and Conditioning Association

Dr.William Davies
(262) 544-5311
1111 Delafield Street #321
Waukesha, WI
Gender
M
Education
Medical School: Med Coll Of Wi
Year of Graduation: 1993
Speciality
Orthopedic Surgeon
General Information
Hospital: Waukesha Memorial Hospital, Waukesha, Wi
Accepting New Patients: Yes
RateMD Rating
1.5, out of 5 based on 1, reviews.

Data Provided By:
Alois Fred Proett
(715) 832-1400
4212 Southtown Dr
Eau Claire, WI
Specialty
Orthopedic Surgery

Data Provided By:
Steven S Davis
(920) 746-0510
323 S 18th Ave
Sturgeon Bay, WI
Specialty
Orthopedic Surgery

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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