Arthroscopic lysis and lavage in different stages of internal derangement of the temporomandibular joint: correlation of preoperative staging to arthroscopic findings and treatment outcome

Wenko Smolka, Tateyuki Iizuka
Journal of Oral and Maxillofacial Surgery 2005, 63 (4): 471-8

PURPOSE: The study was designed to evaluate the outcome of standard arthroscopic lysis and lavage for internal derangement with various levels of severity by comparing the preoperative staging with arthroscopic findings and subsequent success rates.

PATIENTS AND METHODS: Temporomandibular joint disorder in 23 patients (26 joints) who underwent arthroscopic lysis and lavage was preoperatively classified as Wilkes stages II-V based on the clinical and radiologic (magnetic resonance imaging) findings. Recorded arthroscopic findings were scored and compared with the stages. The patients were examined both preoperatively and after a mean follow-up of 22.7 months, using objective and subjective criteria.

RESULTS: The arthroscopic findings showed a correlation between increasing scores and advancing stage. Postoperatively, the patients could be clearly classified into 2 groups with either satisfactory or poor clinical outcome. Overall success rate was 78.3% (18/23). The success rates were slightly lower for patients with advanced stages than for those of stages II and III. Patients totally unresponsive to the treatment were found in all stages.

CONCLUSION: Arthroscopic lysis and lavage is a preferred treatment for different stages of internal derangement. Preoperative staging and corresponding characteristics of the arthroscopic findings do not seem to correlate with the prognosis of the treatment outcome.

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