Arthroscopic management of septic arthritis of temporomandibular joint

• Published in: Oral surgery, oral medicine, oral pathology, oral radiology and endodontics Vol. 109; no. 1; pp. 24 - 30
• Main Authors: Cai, Xie-Yi, PhD, Yang, Chi, PhD, Chen, Min-Jin, MD, Zhang, Shan-Yong, DDS, Yun, Bai
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 2010; Elsevier
• Subjects: Acute Disease; Adult; Anti-Bacterial Agents - therapeutic use; Arthritis, Infectious - pathology; Arthritis, Infectious - surgery; Arthroscopy; Arthroscopy - methods; Biological and medical sciences; Chronic Disease; Dentistry; Diseases of the osteoarticular system; Endoscopy; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Otorhinolaryngology. Stomatology; Retrospective Studies; Surgery; Synovitis - pathology; Temporomandibular Joint - pathology; Temporomandibular Joint - surgery; Temporomandibular Joint Disorders - pathology; Temporomandibular Joint Disorders - surgery; Therapeutic Irrigation; Tissue Adhesions - surgery; Young Adult; Infection; Arthroscopy; Treatment; Diseases of the osteoarticular system; Temporomandibular joint; Arthritis; Endoscopy
• ISSN: 1079-2104; 1528-395X
• DOI: 10.1016/j.tripleo.2009.08.007

This article reports on 7 patients with septic arthritis of the temporomandibular joint (TMJ) who were managed with arthroscopy between 1998 and 2007. The common symptoms were trismus and pain. A series of imaging studies showed widening of joint space in 1 patient with plain film; MRI demonstrated increased joint effusion in 4 patients; accompanying cellulitis in adjacent tissues was discerned by CT in 2 patients. Under the arthroscope, a reddened and swollen synovial membrane was found in 2 patients who were in the acute stage, whereas strong adhesions, destruction of cartilage, and bony defects were discovered in other 5 patients in the chronic stage. Additionally, the disc was ruptured in 3 patients, and fibrosis was confirmed for 2 patients. Lavage, lysis of adhesion, and debridement of articular surface were common procedures for treatments. The average follow-up period was 57.4 months, and no recurrence was found. Arthroscopy has proven to be a useful method for management of septic arthritis of TMJ, especially for patients in the chronic stage.