title: Arthroscopic disc fixation to the condylar head. Use of resorbable pins for internal derangement of the temporomandibular joint (stage II-IV). Preliminary report of 34 joints.
abstract: OBJECTIVE
  The study describes the arthoscopic use of resorbable pins for the internal derangement of the temporomandibular joint with McCain's technique. Clinical and image features are reported retrospectively.
  
  
  METHODS
  Twenty-seven consecutive patients (34 joints) were included. Symptomatic internal derangement and anterior-medial disc displacement with or without reduction in magnetic resonance images (MRI) were diagnosed in all cases. Two resorbable pins (SmartNail) were placed in each joint employing arthroscopic surgery with a third portal for disc recapture and fixation to condylar head. Clinical data 24 months after surgery are reported (movements, pain score, clicking, laterodeviation, occlusal changes). In eight joints a MRI control was required between 1 and 2 years after surgery.
  
  
  RESULTS
  Visual analogue scale values (0-100) decreased from 70.8 to 11.9 (p < 0.001) in the first control (week) and kept down after 24 months of follow-up (VAS: 4.8). Movements began to recover in 3 months and mouth opening increased from 34 mm to 43.2 mm 1 year after surgery (p < 0.001). Clicking, laterodeviation and contralateral excursions improvement were statistically significant (p < 0.001). MRI showed disc fixation to condyle head in closed and opened mouth.
  
  
  CONCLUSIONS
  Disc fixation to condylar head with resorbable pins is a safe and satisfactory procedure. Pain becomes drastically reduced and mandibular function recovers normal parameters in patients with internal derangement.
authors.affiliation: Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario de San Juan de Alicante, Ctra Nnal 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Alicante, Spain. Electronic address: goizu15@hotmail.com.
authors.forename: Carlos C
authors.initials: CC
authors.lastname: Goizueta-Adame
authors.affiliation: Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario de San Juan de Alicante, Ctra Nnal 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Alicante, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pastor-Zuazaga
authors.affiliation: Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario de San Juan de Alicante, Ctra Nnal 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Alicante, Spain.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Orts Bañón
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001858:Bone Nails; D003766:Dental Occlusion; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D017746:Joint Capsule / Q000601:surgery; D004204:Joint Dislocations / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008335:Mandibular Condyle / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D013016:Sound; D019224:Temporomandibular Joint Disc / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D055675:Viscosupplements / Q000627:therapeutic use; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: Arthroscopic disc recapture; TMJ disc fixation; advanced TMJ arthroscopic surgery