title: Outcomes of temporomandibular joint arthroscopy in patients with painful but otherwise normal joints.
abstract: The aim of this retrospective clinical study was to assess the clinical outcomes of temporomandibular joint (TMJ) arthroscopy in patients who presented with category 1 normal joints. The null hypothesis being tested was that patients with normal joints do not respond to TMJ arthroscopy. The clinical records of 116 patients who had undergone TMJ arthroscopy by the author from 2010 to 2013 were retrieved and individually analysed for inclusion in this retrospective, cohort clinical study. The inclusion criteria used to select patients for this study were those who had arthroscopically proven category 1 normal joints, free of intra-articular pathology. Of the 14 patients who were found to have normal joints, only 10 could be contacted for a follow-up survey. Despite the fact that all patients were informed that no joint pathology was found, six out of the 10 patients reported improvement in their temporomandibular disorder (TMD) symptoms that lasted for more than 6 months following TMJ arthroscopy. The results of this investigation indicate that we can reject the null hypothesis, and that patients with normal TMJs do indeed respond to TMJ arthroscopy. What this limited study has highlighted is the pervasive effects of the placebo that all surgeons need to keep in mind when formulating treatment plans for patients with TMD.
authors.affiliation: Department of Surgery, St.Vincent's Hospital Melbourne, The University of Melbourne, Australia. Electronic address: geodim25@gmail.com.
authors.forename: George
authors.initials: G
authors.lastname: Dimitroulis
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D018771:Arthralgia / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D015990:Placebo Effect; D012189:Retrospective Studies; D013704:Temporomandibular Joint / Q000033:anatomy & histology; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics; D007052:Ibuprofen
keywords: Arthroscopy; Outcomes; Placebo; Temporomandibular joint