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Long-term evaluation of meniscectomy of the temporomandibular joint
Abstract:
Meniscectomy for treatment of pain and dysfunction of the temporomandibular joint is a controversial operation because of the possible late complications of limitation of movement and pain. Therefore, the long-term results of this operation were clinically and radiologically investigated in a sample of 15 patients that had had meniscectomies performed during the period from 1947-1960 (mean follow up, 29 years). On clinical examination, all patients were free of pain, none had subjectively experienced dysfunction, and all but one could open their mouths more than 39 mm. Two thirds of the operated joints were crepitant. Radiologically all joints showed structural hard-tissue changes, mainly the presence of osteophytes and flattening of the condyle and tubercle. Absence of joint space was seen in half of the joints. The results indicate that meniscectomy relieves joint pain and eliminates subjectively perceived dysfunction in the long term despite the presence of clinical and radiologic signs of degenerative joint disease; however, as the condition of many patients who have temporomandibular joint disorders improves over time without surgery, there is a need for a controlled study on the value of meniscectomy.
Insights
Temporomandibular joint meniscectomy offers long-term pain relief and improved function. However, degenerative changes persist, necessitating further research into its overall value compared to non-surgical options.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthodontics
- Rheumatology
Background:
- Temporomandibular joint (TMJ) meniscectomy is a debated surgical procedure.
- Potential late complications include restricted movement and persistent pain.
Purpose of the Study:
- To evaluate the long-term clinical and radiological outcomes of TMJ meniscectomy.
- To assess the efficacy of meniscectomy in managing TMJ pain and dysfunction.
Main Methods:
- A cohort of 15 patients who underwent meniscectomy between 1947-1960 was studied.
- Mean follow-up duration was 29 years.
- Clinical examinations and radiological assessments were performed.
Main Results:
- All patients reported pain relief and no subjective dysfunction.
- Mouth opening exceeded 39 mm in all but one patient.
- Radiological findings revealed degenerative changes, including osteophytes and flattened condyles, in all joints.
Conclusions:
- TMJ meniscectomy provides long-term pain relief and functional improvement.
- Significant degenerative joint disease is evident post-surgery.
- Controlled studies are needed to determine the definitive value of meniscectomy versus non-surgical TMJ disorder management.
