Arthroscopic disc suturing for treating TMJ internal derangement

Objective: The purpose of this study was to evaluate effectiveness of a newly arthroscopic disc suturing for treating stage III of internal derangement. Patients and Methods: 353 patients (415 joints), whose stages of ID were from stageII to V, underwent a newly arthroscopic disc suturing during the period of April 2001 to December 2003. Of them, 146 patients (164 joints) were in stage III. The diagnosis was established by physical examination, MRI, and diagnostic arthroscopy. The treatment outcome was judged by Dr. Sanders' criteria for success. Postoperative MRIs were taken at varying intervals between 7 days and 28 months in 46 patients (58 joints). Results: The successful rate was 90.41%(132/146). In successful group, the interincisal opening increased from preoperative 23.01±5.93 mm to postoperative 37.69±3.29mm (P<0.001). The pain scores reduced from 29.76±23.35 to 3.71±7.91(P<0.05). In unsuccessful group, the cases were 14, it was too small to evaluate. In 58 joints of postoperative MRIs, 58.62% (34/58) was normal disc position, and 27.59% (16/58) was partial improvement. The disc positions were improved in 86.21%(50/58). There was no significant difference between clinical evaluation and MRI findings (P>0.05). Conclusions: TMJ disc suturing is an achievable goal of arthroscopy for stage III of ID. The anatomic relocation of the disc is necessary to resolve stage III of ID.