Comparative Analysis of Conventional Flap Surgery vs Laser Assisted Periodontal Flap Surgery: A Report of Two Cases.

The objective of periodontal surgery is to restore periodontal health and to prevent further relapse. Traditionally scalpels were used in periodontal surgery. Recent advancements in laser have set a milestone in the field of periodontal surgery. So considering the above facts, the objective of this case series is to analyze the pre and post–operative results obtained between conventional periodontal flap surgery and diode laser assisted periodontal flap surgery. Two chronic periodontitis patients with generalized probing pocket depth of more than 7mm was selected for this clinical study. Both the patients had angular bone loss in the upper quadrant and generalized horizontal bone loss in the lower quadrant. So scalpel periodontal surgery was planned for the upper quadrant and diode- laser assisted flap surgery in the lower quadrant. Post-operative results based on clinical parameters and patient perspective were recorded. Clinically significant improvement in probing pocket depth and clinical attachment levels were observed in both the surgical sites. Patient acceptance and comfort were more in laser treated sites compared to conventional surgical sites.

Results of Treatment for Acute Deep Infected Total Knee Arthroplasty / 대한정형외과학회잡지

PURPOSE: To evaluate the results of open or arthroscopic debridememt with a retention of the components for acute deep infected total knee arthroplasty. MATERIALS AND METHODS: From January 1991 to December 2005, among 1282 patients, 1457 TKAs, 8 cases of acute deep infected total knee arthroplasty was retrospectively reviewd. A radiologic and clinical assessment were performed to analyze the treatment results. The mean age was 63.9 (57-77) years. One patient was male, and 7 were female. RESULTS: The acute infection rate was 0.55% and the mean follow-up period was 41 months ( range, 30 months to 62 months). Using the Segawa classification, 3 cases were Type 2, and five cases were Type 3. Six cases were treated with arthroscopic debridement and antibiotic therapy. Two cases were treated with open debridement and antibiotic therapy. Intravenous antibiotic therapy was administered over a 3 week period. There were 2 cases of recurred infection. In synovial fluid culture, 4 cases were positive to S. aureus, 2 cases were positive to S. epidermidis and no bacteria was found in 2 cases. At the last follow-up, the mean Knee Society Score was 86.4 points. There were no chronic infection, loosening or osteolytic changes in the implants. CONCLUSION: If an early diagnosis is made, open or arthroscopic debridememt with a retention of the components is a useful method for acute deep infected total knee arthroplasty.

Open Treatment of Anterior Impingement Syndrome of the Ankle in Elite Level Soccer Players / 대한족부족관절학회지

PURPOSE: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. MATERIALS AND METHODS: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. RESULTS: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. CONCLUSION: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.