An arthroscopic technique for closure of perforations in temporomandibular joint retrodiscal tissues

Abstract

The objective of this retrospective study was to introduce and evaluate an arthroscopic discopexy for closure of retrodiscal tissue perforations. A total of 112 patients (135 joints) receiving an arthroscopic discopexy for management of retrodiscal tissue perforations between January 2016 and September 2019 were included. Pre- and postoperative visual analogue scale (VAS) pain scores and maximum inter-incisal opening (MIO), as well as magnetic resonance imaging (MRI) data, were collected and analysed. Success was recorded when the disc position was >11 o’clock, VAS pain score <3, and MIO>25 mm. For patients with a condyle deformity, postoperative bone remodelling was also recorded. The VAS pain score decreased from 3.04 ± 2.66 preoperatively to 0.88 ± 1.13 at 12 months postoperatively (P < 0.001) and MIO increased from 33.90 ± 7.39 mm to 35.19 ± 6.14 mm (P = 0.029). MRI evaluation revealed that 133 discs were successfully repositioned back on top of the condyle. Among these, 11 joints were associated with either VAS pain score ≥3 or MIO ≤25 mm. Therefore, a success rate of 90.4% (122/135) was achieved at 12 months postoperative. Bone remodelling was detected in 72 joints. Arthroscopic discopexy is a minimally invasive and effective treatment for retrodiscal tissue perforations that achieves the purpose of simultaneously restoring the intra-articular structures and relieving clinical symptoms.