OUTCOME OF ARTHROSCOPIC LYSIS AND LAVAGE FOR INTERNAL DERANGEMENT OF THE TEMPOROMANDIBULAR JOINT

Abstract

Background: Temporomandibular Joint (TMJ) diseases have been established to be differentiated between intra-articular and extra-articular problems. TMJ internal derangement categories are the diseases with orthopedic obstacles that require management which might require surgical intervention. Among different surgical interventions, TMJ arthroscopy has been proven to be one of the minimally invasive surgical approaches to tackle TMJ internal derangement. Arthroscopic surgery appears to be a safe, minimally invasive and effective method for treating internal derangements (ID) of the temporomandibular joint (TMJ). Aim: the purpose of this study is to assess the outcome of using arthroscopic lysis and lavage for TMJ ID. Patient and Method: This is a prospective, cohort (27-52y), single institutional clinical study. TMJ ID subjects who failed conservative treatment for two months were presented and treated at the oral and maxillofacial surgery department, faculty of oral and dental medicine, Cairo University. The primary outcome variable was the absence of joint pain at 6 months postoperatively. Secondary outcome variables included joint function and maximum inter-incisal opening (MIO). Patients were followed up for six months postoperatively. Statistical analyses included paired t test and Chi square test. Results: 28 subjects (45;11 unilateral & 34 bilateral), with a mean age of 38.3 years. 24 (85.7%) were females. Successful outcome was seen in 64.4% of the studied subjects. Maximum painless inter-incisal opening as well as visual analog scale for joint pain and function showed a statistical significant improvement at the end of the follow up period.Conclusion: This study showed that TMJ arthroscopic lysis and lavage is an effective and predictable treatment for TMJ ID patients who failed conservative treatment.