Sodium hyaluronate improves outcomes after arthroscopic lysis and lavage in patients with Wilkes stage III and IV disease.
OBJECTIVE
Among patients with Wilkes stage III and IV disease undergoing arthroscopic lysis and lavage, does the use of an intra-articular injection of sodium hyaluronate (SH), when compared with Ringer lavage, result in better postoperative pain control and temporomandibular joint (TMJ) function?


METHODS
We designed and implemented a randomized, double-blind, pilot controlled clinical trial. The study sample was composed of patients with middle Wilkes stage (late stage III and early stage IV) disease. Subjects were randomized to 1 of 2 treatment limbs. The treatment group received Ringer lactate plus an injection of 1 mL of SH after arthroscopy, whereas the control group was given Ringer lactate during arthroscopy. The primary outcome variables were pain and TMJ function measured by use of visual analog scales. Appropriate descriptive and bivariate statistics were computed. A P value less than .05 was considered statistically significant.


RESULTS
The study sample was composed of 40 patients with 20 subjects enrolled in both treatment groups. There were no statistically significant differences between the 2 groups in terms of demographics and preoperative variables. Postoperative analgesia was statistically significant in the treatment group with respect to the control group on the visits on days 14 and 84. No statistically significant differences were observed between the 2 groups in the maximum interincisal opening and tolerance.


CONCLUSIONS
An intra-articular injection of SH after arthroscopic lysis and lavage is effective in reducing pain in patients with TMJ dysfunction, enhancing postsurgical recovery. The analgesic effect of treatment with SH is maintained in the long term.
Department of Oral and Maxillofacial Surgery, Son Dureta University Hospital, Palma de Mallorca, Spain. mmoreym@gmail.com
Miguel-Angel
MA
Morey-Mas
Jorge
J
Caubet-Biayna
Luisa
L
Varela-Sende
José-Ignacio
JI
Iriarte-Ortabe
D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D001182:Arthroscopy; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D007552:Isotonic Solutions; D004204:Joint Dislocations / Q000188:drug therapy / Q000601:surgery; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy; D010865:Pilot Projects; D016059:Range of Motion, Articular / Q000187:drug effects / Q000502:physiology; D000077325:Ringer's Lactate; D019224:Temporomandibular Joint Disc / Q000187:drug effects / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000188:drug therapy / Q000601:surgery*; D007507:Therapeutic Irrigation; D000267:Tissue Adhesions / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage / Q000627:therapeutic use*
D000700:Analgesics; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D055675:Viscosupplements; D006820:Hyaluronic Acid