Prospective study to evaluate the influence of joint washing and the use of hyaluronic acid on 111 arthrocentesis.

Abstract

Temporomandibular dysfunction is a generic term that covers a large number of clinical problems affecting not only temporomandibular joint but also the masticatory musculature and related structures. Arthrocentesis is used in patients with joint pathology in which conservative treatment has failed. A prospective, observational, analytical cohort study has been carried out to evaluate the results of 111 arthrocentesis. We have performed an inferential statistics study between the variables: improvement of pain and improvement in the oral opening with the variables and access joint, washing joint, hyaluronic acid infiltration, and type of joint pathology. Joint washing and intra-articular hyaluronic acid injection significantly improved the pain at 1-week, 1-month, and 3-month postarthrocentesis, although this improvement was limited in time, at 6months, joint washing and hyaluronic acid infiltration are no longer significant. Only the joint access (p = 0.014) and the type of joint pathology (p = 0.028) are significant. The effectiveness of joint access in the arthrocentesis at 6months is high, although less than at 1-month and 3-month postarthrocentesis. The type of joint pathology is another important factor. Patients with degenerative pathology worsen the most after 6-month postarthrocentesis. Arthrocentesis could avoid the evolution of acute pathology.