Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Int J Oral Maxillofac Surg. 2022 May;51(5):669-676. doi: 10.1016/j.ijom.2021.08.002. Epub 2021 Sep 25.
The objective of this retrospective study was to introduce and evaluate an arthroscopic discopexy for closure of retrodiscal tissue perforations. A total of 112 patients (135 joints) receiving an arthroscopic discopexy for management of retrodiscal tissue perforations between January 2016 and September 2019 were included. Pre- and postoperative visual analogue scale (VAS) pain scores and maximum inter-incisal opening (MIO), as well as magnetic resonance imaging (MRI) data, were collected and analysed. Success was recorded when the disc position was >11 o'clock, VAS pain score <3, and MIO>25 mm. For patients with a condyle deformity, postoperative bone remodelling was also recorded. The VAS pain score decreased from 3.04 ± 2.66 preoperatively to 0.88 ± 1.13 at 12 months postoperatively (P < 0.001) and MIO increased from 33.90 ± 7.39 mm to 35.19 ± 6.14 mm (P = 0.029). MRI evaluation revealed that 133 discs were successfully repositioned back on top of the condyle. Among these, 11 joints were associated with either VAS pain score ≥3 or MIO ≤25 mm. Therefore, a success rate of 90.4% (122/135) was achieved at 12 months postoperative. Bone remodelling was detected in 72 joints. Arthroscopic discopexy is a minimally invasive and effective treatment for retrodiscal tissue perforations that achieves the purpose of simultaneously restoring the intra-articular structures and relieving clinical symptoms.
本回顾性研究旨在介绍和评估一种关节镜下盘结扎术治疗盘后组织穿孔。共纳入 2016 年 1 月至 2019 年 9 月期间接受关节镜下盘结扎术治疗盘后组织穿孔的 112 例患者(135 个关节)。收集并分析了术前和术后视觉模拟评分(VAS)疼痛评分和最大张口度(MIO)以及磁共振成像(MRI)数据。当盘位置>11 点、VAS 疼痛评分<3、MIO>25mm 时,记录为成功。对于髁突畸形的患者,还记录了术后骨重塑情况。VAS 疼痛评分从术前的 3.04±2.66 降至术后 12 个月的 0.88±1.13(P<0.001),MIO 从 33.90±7.39mm 增加至 35.19±6.14mm(P=0.029)。MRI 评估显示 133 个盘均成功复位至髁突顶部。其中 11 个关节的 VAS 疼痛评分≥3 或 MIO≤25mm。因此,术后 12 个月的成功率为 90.4%(122/135)。72 个关节检测到骨重塑。关节镜下盘结扎术是治疗盘后组织穿孔的一种微创且有效的方法,可达到同时恢复关节内结构和缓解临床症状的目的。