Evaluation of arthrocentesis with corticosteroids versus arthrocentesis with hyaluronic acid in the management of Temporomandibular joint osteoarthritis

Abstract

Aim: to evaluate the clinical results, radiographic results and levels of inflammatory mediators following arthrocentesis with intra-articular injection of steroids versus arthrocentesis with intra-articular injection of hyaluronic acid in temporomandibular joint osteoarthritis.Materials and Methods: Ten patients suffering from Osteoarthritis with pain and crepitation during jaw movements together with radiographic evidence of bony erosions were included in the study. The patients were divided into two groups, five patients in group A were treated with arthrocentesis followed by intra-articular injection of corticosteroid and five patients in group B were treated with arthrocentesis followed by intra-articular injection of Hyaluronic acid. Results: Patients in both groups showed significant reduction in pain and increase in maximum mouth opening; however, arthrocentesis with intra-articular injection of HA showed better clinical results compared to arthrocentesis with intra-articular injection of corticosteroids. Less inflammatory mediators were found in the Corticosteroid group patients compared to HA group patients. No evidence of new bone formation was seen in both groups after 4 months postoperatively.Conclusion: Better clinical results were achieved after Arthrocentesis followed by intra-articular injection of hyalurionic acid when compared to arthrocentesis with intra-articular injection of corticosteroids. Less inflammatory mediators were associated with arthrocentesis with corticosteroids injection compared to arthrocentesis with HA injection. Long term follow up is required to be able to assess new bone formation following arthrocentesis with intra-articular injection of HA or corticosteroid.