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Updated: Oct 17, 2025
Knee Arthrocentesis in Adults
Published on: February 25, 2022
An additional lysis procedure during arthrocentesis of the temporomandibular joint
Keon-Mo Lee1, Wan-Hee Jang1, Myoung-Sang You1
1Department of Oral and Maxillofacial Surgery, Asan Institute for Life Sciences, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Background:
Arthrocentesis of the temporomandibular joint (TMJ) is an easy, highly efficient, minimally invasive procedure for treating temporomandibular joint disorders (TMDs). However, in some cases of mouth opening limitation (MOL), routine arthrocentesis is ineffective due to severe fibrotic adhesion in the superior joint space of the TMJ. In this condition, mechanical lysis of the adhesions might be needed to resolve the MOL, as well as other symptoms, such as chronic pain. Currently, this can be achieved by arthroscopic surgery or open TMJ surgery. The objective of this study was to introduce and evaluate our trial of the adhesion lysis procedure during arthrocentesis of the TMJ using normal 18-gauge needles.
Results:
In this study, 40 patients with MOL due to disc derangement underwent conventional arthrocentesis at first and then physical detachment was conducted using the same needle. The change in maximum mouth opening (MMO) and the pain at the TMJ were recorded before, during, and after treatment according to our protocol. The mean increase in MMO after conventional arthrocentesis was 6.6 ± 4.2mm. The mean increase in MMO after the detachment procedure with the same needle was 4.2 ± 2.0 mm. The MMO in ten patients was significantly increased after the detachment procedure than after arthrocentesis alone. In all cases, the pain intensity in the TMJ significantly decreased over time, whereas the MMO increased over time. No adverse effect was observed in all joints during our observation periods.
Conclusion:
We confirmed that our simple lysis procedure with the same needle of the arthrocentesis of the TMJ could not only improve the MMO more than after a conventional arthrocentesis but also resolve severe adhesion of the joint space that was ineffective by conventional arthrocentesis. Although this additional lysis procedure is simple, it might reduce the number of cases of more invasive procedures such as arthroscopic surgery or open TMJ surgery.
Insights
This study introduces a simple needle lysis technique during temporomandibular joint (TMJ) arthrocentesis to treat severe adhesions causing mouth opening limitation (MOL). The procedure effectively improved mouth opening and reduced pain, potentially avoiding more invasive surgeries.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthodontics
- Pain Management
Background:
- Temporomandibular joint (TMJ) arthrocentesis is a minimally invasive treatment for TMJ disorders (TMDs).
- Severe fibrotic adhesions in the TMJ superior joint space can render routine arthrocentesis ineffective for mouth opening limitation (MOL).
- Mechanical lysis of adhesions may be necessary, often requiring arthroscopic or open TMJ surgery.
Purpose of the Study:
- To introduce and evaluate a novel adhesion lysis procedure during TMJ arthrocentesis using standard 18-gauge needles.
- To assess the efficacy of this technique in improving mouth opening and reducing pain in patients with MOL due to severe adhesions.
Main Methods:
- Forty patients with MOL due to disc derangement underwent conventional TMJ arthrocentesis.
- A subsequent physical detachment procedure was performed using the same needle to lyse adhesions.
- Maximum mouth opening (MMO) and TMJ pain were recorded before, during, and after treatment.
Main Results:
- Conventional arthrocentesis increased mean MMO by 6.6 ± 4.2 mm.
- The additional needle lysis procedure further increased mean MMO by 4.2 ± 2.0 mm.
- Ten patients showed significant MMO improvement after lysis; all patients experienced decreased TMJ pain and increased MMO over time with no adverse effects.
Conclusions:
- The simple needle lysis procedure during TMJ arthrocentesis effectively improves MMO beyond conventional treatment.
- This technique successfully resolves severe joint adhesions unresponsive to standard arthrocentesis.
- The procedure offers a less invasive alternative, potentially reducing the need for arthroscopic or open TMJ surgery.
