Arthroscopic lysis and lavage in patients with temporomandibular anterior disc displacement without reduction

• Published in: International journal of oral and maxillofacial surgery Vol. 41; no. 1; pp. 109 - 113
• Main Authors: Machoň, V, Šedý, J, Klíma, K, Hirjak, D, Foltán, R
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-01-2012; Elsevier
• Subjects: anterior disc displacement; Arthroscopy; Arthroscopy - methods; Biological and medical sciences; Chronic Disease; Endoscopy; Facial Pain - surgery; Humans; Investigative techniques, diagnostic techniques (general aspects); Joint Dislocations - surgery; lavage; lysis; Medical sciences; Osteoarthritis - surgery; Otorhinolaryngology. Stomatology; Pain Measurement; Prospective Studies; Range of Motion, Articular - physiology; Surgery; Synovitis - surgery; temporomandibular joint; Temporomandibular Joint Disc - surgery; Temporomandibular Joint Disorders - surgery; Therapeutic Irrigation - methods; Time Factors; Tissue Adhesions - surgery; Treatment Outcome; arthroscopy; lysis; temporomandibular joint; anterior disc displacement; lavage; Human; Joint irrigation; Stomatology; Anterior; Temporomandibular joint; Displacement; Reduction; Arthroscopy; Treatment; Surgery; Lysis; Endoscopy
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2011.07.907

Abstract The authors prospectively analysed 50 patients with chronic anterior disc displacement without reduction, who underwent arthroscopic lysis and lavage of the temporomandibular joint (TMJ). Patients with symptoms lasting less than 1 year were assigned to Group A ( n = 28) and patients with symptoms lasting more than 1 year to Group B ( n = 22). The most common problems were inflammatory changes of synovial and retrodiscal tissue (Group A, 71%; Group B, 82%). Fibrous adhesions were present in 14% of Group A patients and 45% of Group B patients. Degenerative changes of the disc and articular surface were present in 4% of Group A patients and 32% of Group B patients. Mouth opening increased 123% from baseline in Group A, and 112% in Group B ( P < 0.05). Pain decreased significantly in both groups (Group A, 2.5 points; Group B, 1.68 points; P < 0.05). In conclusion, almost all patients with chronic anterior disc displacement without reduction benefited from arthroscopic lysis and lavage of the TMJ. Patients with a shorter duration of symptoms problems benefited more than those with a longer duration. Arthroscopic lysis and lavage of the TMJ is safe and beneficial in chronic anterior disc displacement without reduction.