Arthroscopic lysis and lavage for internal derangement of the temporomandibular joint

Abstract

Introduction:Arthroscopy of the temporomandibular joint (TMJ) is a valuable diagnostic and therapeutic tool for various intra-articular disorders, especially internal derangement (ID) of the TMJ.Objectives:To evaluate the efficacy and safety of a standardized arthroscopic procedure for the treatment of two stages of ID; early/intermediate stage and intermediate/late stage.Materials and Methods:Retrospective analysis of medical records of 78 patients (99 joints) treated by arthroscopic lysis and lavage in the authors’ department during a 5-year period. Patients were diagnosed preoperatively as suffering from ID of the TMJ. The results were stratified according to the stage of ID. Three outcome variables were used to assess efficacy of treatment: Maximal interincisal opening (MIO), level of pain on a visual analog scale (VAS), and frequency of intermittent locking episodes. In addition, complications were reported.Results:Mean MIO of the group of patients with intermediate/late stage ID increased from 27 ± 4.7 mm preoperatively to 38 ± 5.4 mm postoperatively (P < 0.0001). For the group of patients with early/intermediate stage ID, mean MIO did not change significantly after arthroscopy (39.1 ± 6.2 mm compared to 41.4 ± 5 mm, P = 0.06), however, subjective evaluation of pain on a VAS decreased from 7.2 ± 1.2 preoperatively to 3.4 ± 2.2 postoperatively (P < 0.0001), and 80% of the patients (25 of 31) denied experiencing intermittent locking episodes after treatment (P < 0.0001).Conclusion:Arthroscopic lysis and lavage is a safe and effective therapeutic modality for the treatment of both mild and advanced stages of ID.

Progress in the Study of Temporomandibular Joint Lavage in Temporomandibular Joint Disorder

“…Temporomandibular joint lavage is mainly used for temporomandibular joint disorders, such as post-traumatic arthritis of the temporomandibular joint, synovial chondromatosis of the temporomandibular joint, fracture of the temporomandibular joint, chronic atresia, which has poor effect on injection treatment, serious pain, and joint cavity exudation. [41][42][43][44][45] This is especially true for synovitis and osteoarthritis, which are not effective with physical therapy alone. But when conservative treatment is invalid or ineffective in patients with severe dysfunction, imaging examination in patients with temporomandibular joint structure obvious change or the temporomandibular joint organization has obvious physical damage, patients with temporomandibular disorders who are unable to live or work normally need timely surgical treatment.…”

Breve evaluación crítica sobre las complicaciones publicadas para la artroscopia de la articulación temporomandibular

“…Edema de los tejidos blandos circundantes, incluido el edema parafaríngeo, del paladar blando y/o preauricular. Dicha complicación se observó en 8 estudios, con tasas de complicación referidas que oscilan entre 0,22 % y 17,9 %, en 2274 articulaciones operadas, 2,[6][7][8][9][10][11]16 lo cual es relevante para ilustrar que esta complicación no es extremadamente infrecuente en muchas series (Figura 1).…”

Intervenções cirúrgicas para o tratamento do deslocamento anterior do disco da articulação temporomandibular (ATM): Revisão de literatura

“…A artroscopia da ATM é uma valiosa ferramenta diagnóstica e terapêutica para vários distúrbios intra-articulares, especialmente distúrbios internos (Abboud et al, 2015). Esta modalidade cirúrgica é mais invasiva que a artrocentese, visto que, utiliza-se de um artroscópio para visualização e reprodução de imagens internas da articulação em tempo real (Grossmann & Grossmann, 2011).…”