Aim This study assessed the patients' and clinicians' perception of the outcome Of temporomandibular joint arthroscopy. Method All patients who underwent TMT arthroscopy for both diagnostic and therapeutic pur...
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Aim This study assessed the patients' and clinicians' perception of the outcome Of temporomandibular joint arthroscopy. Method All patients who underwent TMT arthroscopy for both diagnostic and therapeutic purposes over a 6-year period were sent a questionnaire that asked about various symptoms attributable to the TMJ. Additionally a review of the clinical notes was performed. Results 83 patients underwent arthroscopy to 127 temporomandibular joints. The mean follow up was 3.6 years. 55% of patients assessed their jaw function as being effective, jaw movement, pain control, and overall satisfaction were satisfactory in 37%;57%, and 48% of cases respectively The clinicians' assessment revealed that 45% of patients had no joint tenderness, 74% of patients were able to open to >35 mm and 74% of patients were free of any joint noise. 65% of patients were prepared to undergo a second procedure if indicated. Conclusion Overall, 50% of patients seemed to view arthroscopy favourably although many patients still felt that jaw opening was restricted. The outcome was not related to the position and:reducibility of the disc at surgery and other variables may be responsible. The disparity between the clinical evaluation and the patients' perception of effectiveness emphasises the importance of patient feedback.
We have compared two techniques of arthroscopic surgery for advanced internal derangement of the temporomandibular joint (TMJ). Patients with stage III or above TMJ internal derangement, who had not responded to three...
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We have compared two techniques of arthroscopic surgery for advanced internal derangement of the temporomandibular joint (TMJ). Patients with stage III or above TMJ internal derangement, who had not responded to three months of non-surgical treatment, were prospectively and randomly assigned to one of two types of treatment. One group had arthroscopic lysis and lavage (ALL) and the other had ALL plus arthroscopic anterolateral capsular release (AALCR). All patients were assessed preoperatively, and at 1, 3, 6, and 12 months postoperatively. Thirty-five patients (41 joints) had ALL and 66 patients (73 joints) had AALCR. The only significant difference was at 1 month, when the ALL group could not open their mouths as far as the AALCR group (P < 0.01). Both groups had significantly less pain in the joint anti better jaw opening one year postoperatively. The stage of disease did not affect the outcome. Both ALL and AALCR gave good results in the management of advanced internal derangement of the TMJ. Unless early wide mouth-opening is required, the less invasive procedure of lysis and lavage should be chosen.
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