Efficacy of arthrocentesis and lavage for treatment of post-traumatic arthritis in temporomandibular joints

• 발행기관: 대한구강악안면외과학회
• 저자명: Joo-Young Park Jong-Ho Lee
• 간행물 정보: 『대한구강악안면외과학회지』대한구강악안면외과학회지 제46권 제3호, 174~182쪽, 전체 9쪽
• 주제분류: 의약학 > 내과학
• 파일형태: PDF
• 발행일자: 2020.06.30

영문 초록

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 posttrauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

목차

I. Introduction

II. Materials and Methods

III. Results

IV. Discussion

V. Conclusion

References

키워드

Temporomandibular joint disc Synovial fluid Joint diseases Post-traumatic headache Osteoarthritis