[Arthrocentesis--a highly efficient therapy for acute TMJ arthropathy]. / Die Arthrozentese als hochwirksame Akuttherapie der Kiefergelenkarthralgie.

ABSTRACT

PURPOSE: This clinical study deals with the efficiency of arthrocentesis in acute arthropathy of the temporomandibular joint (TMJ). PATIENTS AND METHODS: In total 142 patients (41.5 years average) were included in the examination. Inclusion criteria were a restriction of mouth opening <40 mm and/or TMJ pain >3 on a visual analog scale (VAS). The first examination took place the day before surgery; follow-up was performed 1 day and 4 weeks after arthrocentesis. Study parameters were active mouth opening, TMJ pain on preauricular or intra-auricular palpation, myalgia of the temporalis or masseter muscle, and a deviation clicking or crepitation during mouth opening. Arthrocentesis was performed in all patients under general anesthesia by a double puncture, continuous rinsing technique in an inferolateral approach as recommended by Murakami. The upper temporomandibular joint space was rinsed with 250 ml of a physiological sterile saline solution and a pressure of 200 mmHg. RESULTS: Arthrocentesis resulted in a highly significant increase of mouth opening and a highly significant reduction of TMJ pain on palpation (p<0.001). CONCLUSION: It can be postulated that TMJ arthrocentesis represents a highly efficient therapy of acute TMJ arthropathy. Whether the results have to be judged as a palliative short-time therapy or if even long-term results can be achieved has to be proved by long-term follow-up studies.