Meniscocondylar plication: a modified operation for surgical repositioning of the ectopic temporomandibular joint meniscus. Rationale and operative technique.

A historical review of temporomandibular joint (TMJ) surgical meniscal repositioning procedures is presented, and three operations that are currently used to manage this problem are compared and contrasted. Each operation produces iatrogenic deviations in intra-articular anatomy and retains the potential to create significant alterations in TMJ biomechanics. Meniscocondylar plication has been performed on 84 patients (89 joints) with arthrographically confirmed internal derangement of the TMJ. A 90.7% success rate was achieved. The operation is technically facile, surgically uncomplicated and clinically effective. It should rank as a justifiable and viable alternative to those operations that are presently being performed to treat patients with internal derangement of the TMJ.