Joint infection as a complication of temporomandibular joint arthroscopy: a case report.
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Adult↗
Biomedical subjects
J P McCain
Publications and source records attributed to J P McCain.
Postarthroscopy physical therapy management of a patient with temporomandibular joint dysfunction.
Arthroscopy of the temporomandibular joint (TMJ) is a new, relatively noninvasive surgical procedure for treating patients with TMJ dysfunction beyond nonsurgical management. The purpose of this commentary is to introduce a four-stage rehabilitation protocol currently used by the authors in the physical therapy management of a postarthroscopy TMJ patient with a diagnosis of bilateral capsular impingement and adhesions. The patient underwent diagnostic TMJ arthroscopy and the four-stage rehabilitation protocol. Stage I exercises to maintain mandibular mobility began in the recovery room. Stage II exercises consisted of hands-on and take-home stretching exercises. Stage III and IV exercises were completed to improve muscular function. The patient was discharged from physical therapy in a month with full range of motion and diminished pain and headaches. At 1-year follow-up, the patient demonstrated full range of motion without pain, further treatment, or medications.
Adult↗
Rehabilitation of the temporomandibular joint after arthroscopic surgery.
Arthroscopy of the temporomandibular joint (TMJ) is a new, relatively noninvasive surgical procedure for treating patients with TMJ dysfunctions beyond management by nonsurgical means. Ninety-two patients who underwent diagnostic and operative TMJ arthroscopy completed a staged physical therapy regimen, which resulted in functional mobility and mandibular use with little or no pain at 24-month follow-up. This report introduces TMJ arthroscopic diagnostic and surgical procedures and their respective rehabilitative protocols currently used to provide beneficial outcomes in postoperative treatment.
Arthroscopy↗
Temporomandibular joint arthroscopy: a 6-year multicenter retrospective study of 4,831 joints.
Four health outcomes (range of motion, pain, diet, and disability) were measured in six diagnostic categories (internal derangement with closed lock, internal derangement with painful click, osteoarthritis, hypermobility, fibrous ankylosis, and arthralgia) in a 6-year retrospective multicenter study of 4,831 temporomandibular joints having undergone arthroscopic surgery. After arthroscopic surgery, 91.6% of all patients had good or excellent motion; 91.3% had good or excellent pain reduction; 90.6% had good or excellent ability to maintain a normal diet; and 92% had a good or excellent reduction in disability. These health outcomes compare favorably with all other known treatments for these conditions. Also, the surgical technique was relatively free of complications (4.4%).
Adolescent↗
Arthroscopic disc repositioning and suturing: a preliminary report.
Eight patients (11 joints) underwent arthroscopic disc repositioning and suturing. Disc displacement was established by physical examination, magnetic resonance imaging (MRI), and diagnostic arthroscopy. Postoperative MRIs were taken at varying intervals between 1 day and 6 months. In all 11 joints, either partial improvement or normal disc position was observed arthroscopically. In 9 of the 11 joints, either partial improvement or normal position was observed on the postoperative MRIs. It is concluded that posterior disc repositioning and suturing is an achievable goal of temporomandibular joint arthroscopy.
Arthroscopy↗
Puncture technique and portals of entry for diagnostic and operative arthroscopy of the temporomandibular joint.
Cadaveric research, expansion of successful arthrography techniques, and improved understanding of normal anatomy, pathology, and open surgery have led to the development of safe, repeatable, and effective puncture techniques and portals of entry in the temporomandibular joint. Single and multiple punctures are described. Two-year outcomes of operative procedures with favorable results are presented for 145 joints in 95 patients. Complications are discussed.
Arthroscopy↗
Preliminary studies on the use of a viscoelastic solution in arthroscopic surgery of the temporomandibular joint.
Arthroscopic surgery of the temporomandibular joint includes the potential for iatrogenic damage of intracapsular structures during introduction of instruments and manipulation of the tissues. A modification of an elastoviscous solution of crosslinked sodium hyaluronate, called hylan fluid, was used for irrigation during surgery in 55 temporomandibular joints. Forty-nine of the joints were monitored postoperatively in a study to measure safety and efficacy of the material during the arthroscopic procedure. The hylan fluid was found to be as safe as the standard irrigating fluid. The hylan fluid also significantly protected the joint surfaces and facilitated the surgical procedure.
Adult↗
Foreign body retrieval: a complication of TMJ arthroscopy. Report of a case.
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Adult↗
Preoperative and postoperative audiologic measurements in patients undergoing arthroscopy of the TMJ.
This article examines the hearing patterns of patients who have undergone arthroscopic surgery using pre- and post-operative pure tone audiometry. Of 29 patients (44 operated joints), one side of one patient showed a decrease of 15 dB immediately postoperatively. On examination there was no apparent anatomic disturbance of the middle or inner ear. The patient regained normal levels of hearing within 2 months. It is concluded that arthroscopic surgery of the TMJ is safe with respect to the middle and inner ear and that it does not affect hearing levels.
Arthroscopy↗
Correlation of clinical, radiographic, and arthroscopic findings in internal derangements of the TMJ.
Arthroscopic, clinical, and imaging observations were compared in 80 temporomandibular joints with suspected internal derangements. Rating scales were developed for assessment of the key arthroscopic findings of "roofing," vascularity, redundancy, articular surface condition, adhesions, and disc function. Clinical and imaging findings were correlated with the rated arthroscopic findings. The degree of roofing was found to have a significant relationship to disc quality and function. Arthroscopy completed the diagnostic picture in these cases and provided detailed information on the joints that was not elicited from clinical findings or imaging studies.
Arthroscopy↗
Arthroscopic observation and treatment of synovial chondromatosis of the temporomandibular joint. Report of a case and review of the literature.
Synovial chondromatosis of the TMJ is a rare disorder of unknown etiology that may be neoplastic or hyperplastic in nature. A histopathologically confirmed case, the first to be identified and treated by arthroscopy, is presented. Removal of the affected synovial tissue and of loose particles was accomplished arthroscopically, a relatively non-invasive alternative to open arthrotomy.
Adult↗
Complications of TMJ arthroscopy.
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Arthroscopy↗
Arthroscopy of the human temporomandibular joint.
Diagnostic arthroscopy of the human temporomandibular joint was investigated on both fresh human cadavers and presurgical arthrotomy patients. It was possible to visualize all of the major anatomic structures in the superior joint space. Inferior joint space techniques were explored on cadavers but not perfected for clinical use. Closed arthroscopic surgical techniques were performed on the cadaver specimens using a variety of instruments such as probes, miniature biopsy forceps, and motorized soft tissue resection and bone abraiding devices.
Arthroscopy↗