Osteochondritis dissecans of the temporomandibular joint: a scoping review.

PURPOSE: To perform a scoping review to identify the available evidence regarding osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ). METHODS: An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: 'Temporomandibular Joint Disorders', 'Osteochondritis Dissecans', 'Joint Loose Bodies' and 'Temporomandibular Joint'. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria. RESULTS: Ten articles were included in the analysis - six case reports, one case series, one retrospective study, one comparative study and one correlational study - with a total of 39 patients. The most frequently reported clinical presentation involved TMJ pain, locked jaw and articular noises (clicking and crepitus). The imaging methods used to identify OCD were radiographs, tomography, arthrography and magnetic resonance imaging. The reported imaging findings varied widely, but the most frequent were (single or multiple) calcified intra-articular loose bodies, signs of degenerative osseous changes, disc displacements, widening of the joint space and alterations in condylar morphology. Seven articles reported treatments (surgical or conservative), but the treatment outcome was not reported in all of the articles, which makes it difficult to make comparisons. CONCLUSION: OCD of the TMJ may present various non-specific clinical characteristics, and given the heterogeneous imaging findings, multiplanar images are required for an accurate diagnosis. Finally, the results do not allow recommending a standard treatment for OCD of the TMJ.

Removal of a Solitary Synovial Chondromatosis of the Temporomandibular Joint Using Arthroscopy.

The diagnosis of synovial chrondromatosis of temporomandibular joint (TMJ) requires a combined assessment consisting of clinical, radiologic, and histopathologic examinations. The purpose of this study is to report in 1 patient the removal of a single large cartilaginous nodule floating in the upper joint compartment using arthroscopy. A 30-year-old woman was referred to our department complaining about pain in preauricular area and restricted mouth opening. Imaging of magnetic resonance reveals anterior disc displacement and right joint effusion. Arthroscopy of TMJ was performed for diagnosis and treatment. During the arthroscopy a large loose body was identified and removed with a biopsy forceps; lavage was conducted with ringer solution. Hyaluronic acid was injected in TMJ at surgery, 1 and 3 months after surgery. Postoperative magnetic resonance imaging showed articular disc on position and no effusion. The patient was followed up of 1 year without sign and symptoms. Arthroscopic procedure of TMJ was effective in diagnosis and removal of a solitary loose body of synovial chrondromatosis. Viscosupplementation appers to offer benefits in controlling pain and functional improvements.

Condromatosis sinovial de cadera. Tratamiento artroscópico / Hip synovial chondromatosis. Arthroscopic treatment

Introducción: La condromatosis sinovial se define como una lesión metaplásica benigna, de baja incidencia en cadera. La técnica ideal de tratamiento genera controversia por la probable recurrencia y la progresión degenerativa descrita para técnicas tanto a cielo abierto como artroscópicas. El objetivo de este trabajo es reportar la técnica quirúrgica y los resultados a corto plazo en una serie de pacientes con condromatosis sinovial de cadera tratados por vía artroscópica. Materiales y Métodos: Entre abril de 2007 y mayo de 2011, 10 pacientes (9 mujeres y 1 hombre, edad promedio 38 años; rango 17-53) fueron operados por vía artroscópica a causa de una condromatosis sinovial de cadera. Se evaluaron la técnica quirúrgica, los resultados clínicos y radiológicos, y el grado de satisfacción con el procedimiento. La escala funcional de Harris modificada preoperatoria fue de 51 puntos (rango 49-54). La histología diferida confirmó el diagnóstico en todos los casos. El seguimiento prospectivo fue, en promedio, de 35 meses (rango 24-47). Resultados: En todos los casos, se realizó una técnica artroscópica convencional para extraer cuerpos libres y sinovectomía parcial anterolateral. En tres pacientes, se amplió la incisión de uno de los portales para extraer cuerpos de gran diámetro. La escala funcional de Harris modificada posoperatoria fue, en promedio, de 88 puntos (rango 85-91). No se observó progreso degenerativo articular radiológico en el último control. Todos los pacientes se mostraron satisfechos con el procedimiento. No se registraron complicaciones. Conclusiones: Los resultados a corto plazo favorables coinciden con los publicados. Los pacientes con condromatosis sinovial de cadera pueden ser tratados por vía artroscópica en forma segura y eficaz. Diseño del estudio: Estudio terapéutico Nivel de evidencia: IV...(AU)

Background: Synovial chondromatosis is defined as a benign metaplastic lesion, with a low incidence in hips. The ideal treatment technique is controversial due to the probable recurrence and degenerative progression described with both arthroscopic and open surgery. The aim of this study is to report the surgical technique and shortterm results in a series of patients with synovial chondromatosis treated with arthroscopic hip. Methods: From April 2007 to May 2011, 10 patients (9 women and a man; average age 38 years; range 17-53) underwent hip arthroscopy for synovial chondromatosis. Surgical technique, clinical and radiological results, and satisfaction with the procedure were evaluated. The preoperative modified Harris hip functional scale was 51 points (range 49-54). Delayed histology confirmed diagnosis in all cases. Prospective follow-up averaged 35 months (range 24-47). Results: The conventional arthroscopic technique to extract loose bodies and partial anterolateral synovectomy were performed in all patients. In three patients incision of one of the portals was extended to extract bodies of large diameter. The postoperative modified Harris hip functional scale averaged 88 points (range 85-91). No radiographic joint degenerative progress was seen at the last control. All patients were satisfied with the procedure. There were no complications. Conclusions: Favorable short-term results are consistent with those reported in the literature. Patients with synovial chondromatosis can be treated with hip arthroscopy safely and effectively. Design of the Study: Therapeutic. Level of Evidence: IV...(AU)

Condromatosis sinovial de cadera. Tratamiento artroscópico / Hip synovial chondromatosis. Arthroscopic treatment

Introducción: La condromatosis sinovial se define como una lesión metaplásica benigna, de baja incidencia en cadera. La técnica ideal de tratamiento genera controversia por la probable recurrencia y la progresión degenerativa descrita para técnicas tanto a cielo abierto como artroscópicas. El objetivo de este trabajo es reportar la técnica quirúrgica y los resultados a corto plazo en una serie de pacientes con condromatosis sinovial de cadera tratados por vía artroscópica. Materiales y Métodos: Entre abril de 2007 y mayo de 2011, 10 pacientes (9 mujeres y 1 hombre, edad promedio 38 años; rango 17-53) fueron operados por vía artroscópica a causa de una condromatosis sinovial de cadera. Se evaluaron la técnica quirúrgica, los resultados clínicos y radiológicos, y el grado de satisfacción con el procedimiento. La escala funcional de Harris modificada preoperatoria fue de 51 puntos (rango 49-54). La histología diferida confirmó el diagnóstico en todos los casos. El seguimiento prospectivo fue, en promedio, de 35 meses (rango 24-47). Resultados: En todos los casos, se realizó una técnica artroscópica convencional para extraer cuerpos libres y sinovectomía parcial anterolateral. En tres pacientes, se amplió la incisión de uno de los portales para extraer cuerpos de gran diámetro. La escala funcional de Harris modificada posoperatoria fue, en promedio, de 88 puntos (rango 85-91). No se observó progreso degenerativo articular radiológico en el último control. Todos los pacientes se mostraron satisfechos con el procedimiento. No se registraron complicaciones. Conclusiones: Los resultados a corto plazo favorables coinciden con los publicados. Los pacientes con condromatosis sinovial de cadera pueden ser tratados por vía artroscópica en forma segura y eficaz. Diseño del estudio: Estudio terapéutico Nivel de evidencia: IV...

Background: Synovial chondromatosis is defined as a benign metaplastic lesion, with a low incidence in hips. The ideal treatment technique is controversial due to the probable recurrence and degenerative progression described with both arthroscopic and open surgery. The aim of this study is to report the surgical technique and shortterm results in a series of patients with synovial chondromatosis treated with arthroscopic hip. Methods: From April 2007 to May 2011, 10 patients (9 women and a man; average age 38 years; range 17-53) underwent hip arthroscopy for synovial chondromatosis. Surgical technique, clinical and radiological results, and satisfaction with the procedure were evaluated. The preoperative modified Harris hip functional scale was 51 points (range 49-54). Delayed histology confirmed diagnosis in all cases. Prospective follow-up averaged 35 months (range 24-47). Results: The conventional arthroscopic technique to extract loose bodies and partial anterolateral synovectomy were performed in all patients. In three patients incision of one of the portals was extended to extract bodies of large diameter. The postoperative modified Harris hip functional scale averaged 88 points (range 85-91). No radiographic joint degenerative progress was seen at the last control. All patients were satisfied with the procedure. There were no complications. Conclusions: Favorable short-term results are consistent with those reported in the literature. Patients with synovial chondromatosis can be treated with hip arthroscopy safely and effectively. Design of the Study: Therapeutic. Level of Evidence: IV...

Arthrocentesis in the treatment of loose bodies of the temporomandibular joint associated with synovial chondromatosis.

Synovial chondromatosis is a benign disorder of joints of unknown aetiology, characterised by the presence of loose bodies in the articular space. We present a case that affected the temporomandibular joint (TMJ) and was treated with arthrocentesis, which is an efficient, conservative, and inexpensive treatment.

Remoçäo artroscópica de corpos livres endoarticulares do joelho: técnicas e resultados / Removal of loose bodies from the knee under arthroscopic control: techniques and results

Os autores, depois de descreverem a técnica, relatam os resultados de 85 intervençöes cirúrgicas de remoçäo artroscópica de corpos livres endoarticulares do joelho. As vantagens com a técnica a "céu fechado" consistem na individualizaçäo dos corpos livres radiotransparentes, näo visíveis ao exame radiológico pré-operatório, e na remoçäo de corpos livres situados em áreas de difícil acesso artrotômico