The incidence of reoperation after temporomandibular joint arthroscopic surgery: a retrospective study of 450 consecutive joints.
OBJECTIVE
The purpose of this study was to investigate the incidence of reoperation after temporomandibular joint arthroscopic surgery in 315 consecutive patients (488 joints).


METHODS
The clinical data and operative reports of all patients who underwent arthroscopic procedures from 1995 to 2000 were reviewed retrospectively. Patients had a preoperative clinical and panoramic radiographic evaluation. Most of the patients had disk displacement without reduction. In the remaining patients, the intra-articular pathologic conditions ranged from disk displacement with reduction to degenerative joint disease. The outcome assessment was based on reduction in pain, improvement in vertical dimension of mouth opening, and mandibular excursions. The same surgical team performed all arthroscopic procedures. Before surgery, all patients received at least 3 to 6 months of nonsurgical therapy consisting of anti-inflammatory medications, muscle relaxants, splint therapy, physiotherapy, exercise, moist heat, cold laser, ultrasound, and soft diet or a combination thereof. Patients were monitored postoperatively for as long as 5 years.


RESULTS
Results showed that approximately 20% of those patients who had temporomandibular joint arthroscopic surgery underwent further temporomandibular joint procedures ranging from repeat arthroscopic surgery to open-joint arthrotomy.


CONCLUSIONS
Temporomandibular joint surgical arthroscopy is an appropriate therapeutic modality for patients with temporomandibular joint internal derangements, with reoperation required for only 20% of patients.
Abd-Ul-Salam
Hani
H
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Toronto, Ontario, Canada. hani@ca.inter.net
Weinberg
Simon
S
Kryshtalskyj
Bohdan
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001182:Arthroscopy / Q000706:statistics & numerical data*; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D015994:Incidence; D004204:Joint Dislocations / Q000601:surgery; D053685:Laser Therapy; D008297:Male; D008334:Mandible / Q000503:physiopathology; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use; D017090:Occlusal Splints; D010003:Osteoarthritis / Q000601:surgery; D010147:Pain Measurement; D011862:Radiography, Panoramic; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013704:Temporomandibular Joint / Q000503:physiopathology / Q000601:surgery*; D019224:Temporomandibular Joint Disc / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000601:surgery; D016896:Treatment Outcome; D014464:Ultrasonic Therapy
D000893:Anti-Inflammatory Agents; D009465:Neuromuscular Agents