Arthroscopic Discopexy Techniques for Articular Disc Displacement: A Systematic Review and Meta-Analysis

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Biomedical Engineering

Background:

• Anterior disc displacement (ADD) is a prevalent temporomandibular joint (TMJ) disorder that can lead to internal derangements.
• Arthroscopic discopexy, a minimally invasive technique for disc repositioning and fixation, is increasingly adopted for ADD.
• A comprehensive synthesis of suggested techniques and pooled outcomes for arthroscopic discopexy is lacking.

Purpose of the Study:

• To systematically review and meta-analyze the effectiveness of arthroscopic discopexy in treating TMJ disc disorders.
• To synthesize pooled outcomes regarding TMJ function (MIO), pain reduction (VAS), and joint sounds.

Main Methods:

• Systematic review and meta-analysis adhering to Cochrane and PRISMA 2020 guidelines.
• Searched four databases up to September 1, 2025, including 26 studies (9 for meta-analysis, 17 for narrative synthesis).
• Analyzed continuous outcomes (MIO, pain score) as mean differences and joint sounds as dichotomous outcomes; assessed certainty with GRADE.

Main Results:

• Arthroscopic discopexy demonstrated significant improvements in MIO (MD: 10.58 mm), pain scores (MD: -4.36), and reduced joint sounds (OR: 0.07) at 12 months.
• Improvements in MIO and pain were consistent across all follow-up time points analyzed.
• Overall certainty of evidence was rated as low due to high heterogeneity and observational nature of included studies.

Conclusions:

• Arthroscopic discopexy shows significant potential in enhancing TMJ function and alleviating symptoms associated with ADD.
• Current evidence, despite low certainty, supports the advantages of arthroscopic discopexy.
• High-quality randomized controlled trials with standardized protocols and longer follow-up are recommended to confirm these findings.