EVALUATION OF ARTHROSCOPIC DISC REPOSITIONING: A PROSPECTIVE STUDY

Abstract

Aim: To evaluate clinical outcomes and success rates of our arthroscopic disc repositioning and suturing technique in patients with internal derangements of the temporomandibular joint (TMJ). Materials and methods: This was a prospective study in selected patients who met certain criteria. At baseline, we collected the information on their age, gender, disease duration, and the operated TMJ. Preoperative and postoperative variables included joint pain, joint clicking, maximal inter-incisal opening, mandibular protrusion, and lateral movements. Postoperative assessments were also performed, including magnetic resonance imaging (MRI) scans, assessment of numbness, scar, diet, and quality of life. All patients were assessed preoperatively and at 1, 3, 6, 12 months after the arthroscopic surgery. An independent t-test was used to assess the quantitative data and chi-square test was applied to the binary data. Results: The study was completed in 224 joints from 179 patients. Their mean age was 21.35 ± 8.71 years. Joint pain and quality of life improved significantly at 1 month of the follow-up, and almost vanished at 3 months of the follow-up. Frequency of joint clicking was significantly lower at 1 month of the follow-up, but increased significantly at 3 months of the follow-up. Numbness was significantly reduced at 12 months after surgery. Dietary and scar improvements were obvious at 3 months after surgery. Jaw movements were significantly improved at 12 months after the surgery. The success rate of the disc position evaluated by MRI decreased slightly from 99.6% to 97.8% at 1 month and 12 months of the follow-up. Conclusion: Our arthroscopic disc repositioning technique is an effective surgical method not only to improve the joint functioning, but also to correct the disc displacement for a relatively long time. It can be regarded as an appealing technique for the treatment of TMJ internal derangements.