title: Efficacy of arthroscopic lysis and lavage in patients with chronic locking of the temporomandibular joint.
abstract: This prospective 1-year follow-up investigated the efficacy of temporomandibular joint lysis and lavage in relation to arthroscopic diagnoses. The study comprised 42 patients. Clinical evaluation was performed before surgery and at regular intervals up to 1 year postoperatively. Diagnostic arthroscopy and immediately subsequent lysis and lavage were performed under local anesthesia in all patients. Only unilateral upper compartment arthroscopies were executed. The results were evaluated according to the 1984 criteria of the American Association of Oral and Maxillofacial Surgeons. Osteoarthrosis was diagnosed arthroscopically in 30 joints (71%), 21 of which (70%) had more pronounced changes. Synovitis, mainly of a mild, localized type, was diagnosed in 39 joints (93%). More pronounced synovitis was found arthroscopically in 12 (31%). Adhesions were found in 20 joints (48%) and were significantly correlated with joints displaying osteoarthrosis (P < 0.001). The overall success rate for arthroscopic lysis and lavage was 50% (21/42 joints). The best response to lysis and lavage was in joints with arthroscopic diagnosis of pronounced synovitis (8/12 joints; 67%). All 21 joints regarded as unsuccessful were operated with diskectomy without implants. The success rate at 1-year follow-up was 18 joints (86%).
authors.affiliation: Department of Oral and Maxillofacial Surgery, Karolinska Institutet, Huddinge, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Holmlund
authors.forename: G
authors.initials: G
authors.lastname: Gynther
authors.forename: S
authors.initials: S
authors.lastname: Axelsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013585:Synovitis / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D007507:Therapeutic Irrigation; D000267:Tissue Adhesions / Q000601:surgery