Consultant Oral and Maxillofacial Surgeon, Department of Oral & Maxillofacial Surgery, The University Hospital of Skåne, 22185 Lund, Sweden.
Department of Oral & Maxillofacial Surgery, The University Hospital of Skåne, 22185 Lund, Sweden.
J Stomatol Oral Maxillofac Surg. 2021 Sep;122(4):e21-e26. doi: 10.1016/j.jormas.2021.03.003. Epub 2021 Apr 9.
Arthroscopic treatment of the temporomandibular joint (TMJ) has traditionally been evaluated with clinical measurements. Additional recordings of patient reported outcome measures (PROM) is expected to make the evaluation more complete. The aim of the study was to evaluate if PROM correlates with clinical follow-up measures after arthroscopic treatment of internal derangement of the TMJ.
Patients with temporomandibular dysfunction (TMD), treated with arthroscopic lysis and lavage of the TMJ, were followed with a PROM questionnaire; Jaw Functional Limitation Scale 20 (JFLS-20) and a review of patient medical records. Out of 239 patients treated, 134 were eligible for inclusion to the study.
91 subjects, 21 males and 70 females, with mean age 42.6 years completed the follow-up. The JFLS-20 mean score was 25.43 (range: 0-148). A correlation was found between JFLS and mouth opening. The JFLS-20 score was decreased by 1.48 (p = 0.0001) for ever millimeter larger mouth opening and with 1.16 (p = 0.001) for every gained millimeter of mouth opening after arthroscopic treatment of the TMJ. The mean maximal mouth opening was 38.43 mm preoperatively (15 to 75 mm) compared to 42.19 mm postoperatively (range: 21-75 mm). A total of 80 subjects with TMD associated pain preoperatively was reduced to 25 postoperatively (p = 0.0001).
Advantageous treatment effect with arthroscopic lysis and lavage was presented. The outcome of the JFLS-20 questionnaire indicates a correlation with the clinical findings. Future studies will focus on larger cohorts and using PROM with a case-control setting.
关节镜下治疗颞下颌关节（TMJ）传统上通过临床测量进行评估。预计患者报告的结果测量（PROM）的额外记录将使评估更加完整。本研究的目的是评估 TMJ 关节内紊乱关节镜治疗后 PROM 是否与临床随访测量相关。
患有颞下颌功能障碍（TMD）的患者接受 TMJ 关节镜松解和灌洗治疗，并用 PROM 问卷；下颌功能限制量表 20（JFLS-20）和患者病历回顾进行随访。在 239 例接受治疗的患者中，有 134 例符合纳入研究的条件。
91 名受试者，21 名男性和 70 名女性，平均年龄 42.6 岁，完成了随访。JFLS-20 的平均得分为 25.43（范围：0-148）。发现 JFLS 与张口度之间存在相关性。TMJ 关节镜治疗后，张口每增加 1 毫米，JFLS-20 评分降低 1.48（p=0.0001），张口增加 1.16 毫米（p=0.001）。TMJ 关节镜治疗前平均最大张口度为 38.43mm（15-75mm），治疗后为 42.19mm（范围：21-75mm）。术前 80 例 TMD 相关疼痛患者减少至 25 例术后（p=0.0001）。
关节镜松解和灌洗治疗效果有利。JFLS-20 问卷的结果表明与临床发现相关。未来的研究将集中在更大的队列中，并使用 PROM 进行病例对照研究。
