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[A clinical study on septic arthritis of temporomandibular joint: treatment]
Chi Yang1, Xie-yi Cai, Zhi-yuan Zhang
1Dept. of Oral & Maxillofacial Surgery, Afficiated Ninth People's Hospital, Shanghai Second Medical University, Shanghai 200011, China. yangchi63@hotmial.com
Objective:
To investigate the procedure and effect on treating septic arthritis of temporomandibular joint (TMJ).
Methods:
30 patients were treated by antibiotic therapy, resting of the jaw, and local therapies. The local therapies included arthrocentesis with single needle in 20 joints, arthrocentesis with double needles in 13, arthrocentesis accompanied by submandibular drainage of the infratemporal space abscess in 1, and arthroscopy in 4. The therapeutic effects were judged by joint cavity puncture, mouth opening, jaw pain, and jaw function, and so on. Sequelae were evaluated.
Results:
The overall success rate of the treatment was 100% (30/30). The success rates of the 4 different management were: 14/20 in arthrocentesis with single needle, 9/13 in arthrocentesis with double needles, 1/1 in arthrocentesis combined with submandibular drainage, and 4/4 in arthroscopy, respectively. The sequelae were mild, and most of the cases had only postinfectious osteoarthritis.
Conclusions:
Low pressure arthrocentesis, antibiotic therapy and resting of the jaw were important components of treatment in acute septic arthritis. If infratemporal space abscess was found, submandibular drainage should be done. Arthroscopy could be recommended to those who haven't got good results by arthrocentesis or those who have already had some sequelae, such as TMJ fibrous ankylosis.