Factors Associated With Successful Outcomes Following Arthroscopic Discopexy for Symptomatic Disc Displacement

Symptomatic disc displacement (SDD) is a common temporomandibular joint disorder, with arthroscopic discopexy being one of the treatment options that offers the advantages of a minimally invasive approach.

The purpose was to evaluate factors associated with favorable outcomes after mattress-loop technique (Yang's technique) for arthroscopic discopexy in subjects with SDD.

This prospective cohort study was conducted at a tertiary care center (Clínica Bupa Santiago). Patients presenting between 2022 and 2024 with SDD who required arthroscopic discopexy were enrolled. Exclusion criteria included missing preoperative data or unavailable preoperative magnetic resonance imaging (MRI).

The predictor variable was a set of heterogenous variables categorized as demographic, perioperative, or imaging.

The main outcome variable was therapeutic effect measured using (1) visual analog scale to assess pain and (2) maximal incisal opening (MIO). The secondary outcome was radiographic, measured using disc stability assessed on 6-month MRI based on disc position. All variables were measured at baseline and at 6 months postoperatively.

Not applicable.

Data were analyzed using descriptive and inferential statistics, a statistical significance was set at P value < .05. Mixed-effects regression models with a random intercept for patient to account for correlation between joints within the same individual were performed for changes in pain, MIO, and disc position stability.

A total of 218 joints from 141 subjects were included. At 6 months, pain decreased from a mean of 5.53 ± 2.42 to 0.81 ± 1.60 (Δ = 4.72, P < .05) and MIO increased from 31.29 ± 9.13 mm to 38.52 ± 4.61 mm (Δ = 7.23 mm, P < .05). MRI follow-up showed disc stability in 120 joints (89.5%). Female sex, younger age, and the presence of clicking were significantly associated with greater improvements in pain and MIO. After adjusting for males experienced significantly less pain reduction (β = -1.56, P = .03), and younger subjects (β = -0.17 mm/year, P = .002) had better pain relief and improved MIO respespectively.

The results suggest that mattress-loop technique was associated with reducing pain, increasing MIO, and preserving short-term disc stability at 6 months. Younger age was the strongest predictor of favorable outcomes, supporting early intervention in this population.