颞下颌关节关节腔穿刺术在退行性关节病患者中的应用：10 至 22 年随访研究。

Temporomandibular Joint Arthrocentesis in Patients with Degenerative Joint Disease: A 10- to 22-year Follow-up.

出版信息

J Oral Facial Pain Headache. 2021;35(2):113-118. doi: 10.11607/ofph.2871.

Abstract

AIMS

To report the effectiveness of temporomandibular joint (TMJ) arthrocentesis with viscosupplementation for degenerative joint disease (DJD) over a long-term (ie, 10-22 years) follow-up.

METHODS

A total of 103 patients aged between 30 and 91 years (13 men and 90 women; mean age 63.7 years) who received a cycle of five arthrocentesis sessions with HA viscosupplementation to manage their symptoms related to TMJ DJD during the time period from 1998 to 2010 were recalled for clinical evaluation. After the treatment cycle, clinical outcomes were assessed based on the following parameters: maximum mouth opening (MO), pain with function (PF), pain at rest (PR), and self-reported chewing efficiency (CE). Data were collected at baseline (T) and at successive follow-up assessments, after at least 3 months (T) and 1 year (T), as per previous publications. Patients who had received treatment at least 10 years prior were then recalled for this study (T: 10 to 22 years follow-up). Analysis of variance for repeated measures was performed to assess changes over time.

RESULTS

Significant improvement in all clinical parameters was achieved at T and was maintained for up to 10 years (T), with P < .01 for each parameter. At T, treatment effectiveness was perceived as excellent by 56% and as good by 26.5% of subjects, while 10.7% perceived a moderate improvement, and 6.8% referred a slight improvement or did not have any improvement. Only seven individuals required additional treatments after T.

CONCLUSION

These findings suggest that the symptomatic management of TMJ DJD achieved in the short or medium term with a cycle of arthrocentesis and viscosupplementation was effectively maintained in the long term.

摘要

目的

报告颞下颌关节（TMJ）关节内穿刺术联合透明质酸钠注射治疗退行性关节疾病（DJD）的长期（即 10-22 年）随访效果。

方法

共召回了 103 名年龄在 30 至 91 岁之间（13 名男性和 90 名女性；平均年龄 63.7 岁）的患者，他们在 1998 年至 2010 年期间接受了五轮 TMJ DJD 相关症状的关节内穿刺术联合透明质酸钠注射治疗。在治疗周期结束后，根据以下参数评估临床疗效：最大张口度（MO）、功能相关疼痛（PF）、静息时疼痛（PR）和自我报告的咀嚼效率（CE）。数据在基线（T）和随后的随访评估时收集，至少在 3 个月（T）和 1 年（T）后，根据之前的出版物进行评估。对于至少在 10 年前接受过治疗的患者，将其召回进行本研究（T：10-22 年随访）。采用重复测量方差分析评估随时间的变化。

结果

在 T 时，所有临床参数均显著改善，并在长达 10 年的时间内保持稳定（T），每个参数的 P 值均<0.01。在 T 时，56%的患者认为治疗效果极好，26.5%的患者认为治疗效果良好，10.7%的患者认为有中度改善，6.8%的患者认为有轻度改善或没有改善。只有 7 名患者在 T 后需要额外的治疗。