Synovial Plicae and Temporomandibular Joint Disorders: Surgical Findings

Abstract

Synovial plicae and their relation to pain and disability have been reported in the orthopedic literature in association with the knee and other extremity joints. However, the occurrence of synovial plicae in the temporomandibular joint (TMJ) have rarely been reported. This report describes the surgical appearance, distribution, and histologic findings of synovial plicae in patients with TMJ recurrent dislocation and internal derangement. Twenty consecutive patients, 16 with recurrent dislocation and 4 with internal derangement, who underwent open TMJ surgery by the same surgeon from 2010 to 2013 were studied retrospectively. Synovial plicae were detected in 18 of 28 joints (64.3%). Synovial plicae were observed in 15 of 24 joints (62.5%) with recurrent dislocation and in 3 of 4 joints (75%) with internal derangement. Histologic findings of these plicae were consistent with dense fibrous or cartilaginous tissues, with some exhibiting a synovial lining. Although the role of synovial plicae in TMJ disorders is unknown and unstudied, consideration should be given to investigating the possible relation of these structures to the signs and symptoms of TMJ disorders.