Long-term evaluation of arthroscopic surgery with lysis and lavage of temporomandibular joint disorders.

Aim: To estimate and analyse the long-term outcome of arthroscopy for the treatment of the temporomandibular joint (TMJ) internal derangements.

Patients And Methods: Twenty-nine patients (35 joints) who underwent TMJ arthroscopy under general anaesthesia due to osteoarthritis between years 2000 and 2007 (Wilkes stages IV and V) were included in this study. The age range at the time of surgery was from 18 to 69 years. The scores for preoperative maximal interincisal opening (MIO), and visual analogue scale (VAS) score for pain before arthroscopy, 6 months and 5 years after arthroscopy were compared.

Results: Fibrous adherences were found in all cases, fibrillations in 76% of cases. The most frequent radiographic sign was erosion (69%). There was a significant increase in the MIO postoperatively after 6 months (r(s)=0.56; n=29, p>0.01) that held during the longer-term follow-up (5 years) period (r(s)=0.58; p<0.001). VAS after 6 months was positively correlated to VAS after 5 years (r(s)=0.38; p=0.040). There were no significant differences between the results of follow-up when comparing the shorter (6 months) and longer (5 years) results.

Conclusion: Arthroscopic lysis and lavage for the treatment of TMJ disorders offers favourable long-term stable results with regard to increasing MIO and reduced pain and dysfunction.