EFFICACY OF ARTHROSCOPIC LYSIS AND LAVAGE IN PATIENTS WITH CHRONIC LOCKING OF THE TEMPOROMANDIBULAR-JOINT

This prospective 1-year follow-up investigated the efficacy of temporo mandibular joint lysis and lavage in relation to arthroscopic diagnose s. The study comprised 42 patients. Clinical evaluation was performed before surgery and at regular intervals up to 1 year postoperatively. Diagnostic arthroscopy and immediately subsequent lysis and lavage wer e performed under local anesthesia in all patients. Only unilateral up per compartment arthroscopies were executed. The results were evaluate d according to the 1984 criteria of the American Association of Oral a nd Maxillofacial Surgeons. Osteoarthrosis was diagnosed arthroscopical ly in 30 joints (71%), 21 of which (70%) had more pronounced changes. Synovitis, mainly of a mild, localized type, was diagnosed in 39 joint s (93%). More pronounced synovitis was found arthroscopically in 12 (3 1%). Adhesions were found in 20 joints (48%) and were significantly co rrelated with joints displaying osteoarthrosis (P<0.001). The overall success rate for arthroscopic lysis and lavage was 50% (21/42 joints). The best response to lysis and lavage was in joints with arthroscopic diagnosis of pronounced synovitis (8/12 joints; 67%). Ah 21 joints re garded as unsuccessful were operated with diskectomy without implants. The success rate at 1-year follow-up was 18 joints (86%).