Predictive factors in temporomandibular joint arthroscopy: a prospective cohort short-term outcome study

Improving the outcomes of surgical treatment of the temporomandibular joint (TMJ) is beneficial from a patient and health-economy perspective. Optimizing conditions for a successful result can be reached using validated, strict diagnostic criteria and by identifying patient-specific factors predicting the outcome. The aim of this study was to investigate possible predictive factors in TMJ arthroscopy. A prospective cohort study including 93 patients undergoing arthroscopy was conducted. The outcome was graded as successful (53%, n=49), good (25%, n=23), intermediate (20%, n=19), or deteriorated (2%, n=2) using a predefined set of objective and subjective outcome measures. The outcome was correlated with preoperative and perioperative variables and the diagnosis. Preoperative bilateral masticatory muscle tenderness on palpation was the only variable significantly correlated with a negative outcome in the adjusted regression analysis (odds ratio (OR) 2.56, P=0.048). Low age (OR 1.03, P=0.05) and bilateral joint surgery/operated side (OR 0.24, P=0.05) were found to correlate with an unsuccessful outcome in the unadjusted analysis. Eighty-nine percent of the patients with osteoarthritis benefited from arthroscopy, while corresponding figures were 80% for disc displacement without reduction and 64% for chronic inflammatory arthritis. Preoperative bilateral masticatory tenderness might be a useful predictive factor suggesting the consideration of revised non-invasive therapy before surgery.