title: Arthroscopic management for synovial chondromatosis of the temporomandibular joint: a retrospective review of 33 cases.
abstract: OBJECTIVE
  To present clinical, radiologic, and arthroscopic results of patients with synovial chondromatosis of the temporomandibular joint; to introduce a technique for removal of loose bodies in different areas; and to summarize the indications of therapeutic arthroscopy according to the magnetic resonance imaging (MRI) features.
  
  
  METHODS
  From April 2001 to April 2010, 33 consecutive patients underwent arthroscopy. Their demographics, clinical manifestations, imaging studies, arthroscopic findings, treatments, and outcomes were reviewed.
  
  
  RESULTS
  The predominant symptoms were pain, limitation of mouth opening, and joint sounds. Obvious joint effusion was shown on MRI in 21 of 33 patients. Mass lesions were shown on MRI in 29 of 33 cases. The presence of loose bodies was shown in 31 cases under an arthroscope. Synovial hyperplasia was noted in 12 patients. Bony erosion of the articular surface was discovered in 11 patients. Thirty-two patients underwent therapeutic arthroscopy. Smaller loose bodies were commonly removed with joint lavage or biopsy forceps in 24 patients. Fragmentation with forceps or a wider additional incision was applied to remove larger loose bodies in 7 patients. Debridement was applied to remove intrasynovial lesions in 7 patients. Coblation was used to remove the hyperplastic synovium in 10 of 32 patients. Eight patients were lost to follow-up. The mean follow-up period was 38 months. No recurrence was suspected clinically and radiologically.
  
  
  CONCLUSIONS
  Therapeutic arthroscopy was appropriate for patients with separate mass lesions and no extra-articular extension. Surgical treatment comprised thorough removal of loose bodies and affected synovial tissues.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Xie-Yi
authors.initials: XY
authors.lastname: Cai
authors.forename: Chi
authors.initials: C
authors.lastname: Yang
authors.forename: Min-Jin
authors.initials: MJ
authors.lastname: Chen
authors.forename: Bin
authors.initials: B
authors.lastname: Jiang
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhou
authors.forename: Jia-Min
authors.initials: JM
authors.lastname: Jin
authors.forename: Bai
authors.initials: B
authors.lastname: Yun
authors.forename: Zhuo-Zhi
authors.initials: ZZ
authors.lastname: Chen
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001706:Biopsy / Q000295:instrumentation; D002356:Cartilage / Q000473:pathology; D015838:Chondromatosis, Synovial / Q000601:surgery*; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D004204:Joint Dislocations / Q000601:surgery; D007594:Joint Loose Bodies / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D000074402:Synovectomy; D013582:Synovial Fluid; D013583:Synovial Membrane / Q000473:pathology; D013701:Temporal Bone / Q000473:pathology; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D055815:Young Adult