Holmlund A, Gynther G, Axelsson S
Department of Oral and Maxillofacial Surgery, Karolinska Institutet, Huddinge, Sweden.
Int J Oral Maxillofac Surg. 1994 Oct;23(5):262-5. doi: 10.1016/s0901-5027(05)80104-3.
This prospective 1-year follow-up investigated the efficacy of temporomandibular joint lysis and lavage in relation to arthroscopic diagnoses. The study comprised 42 patients. Clinical evaluation was performed before surgery and at regular intervals up to 1 year postoperatively. Diagnostic arthroscopy and immediately subsequent lysis and lavage were performed under local anesthesia in all patients. Only unilateral upper compartment arthroscopies were executed. The results were evaluated according to the 1984 criteria of the American Association of Oral and Maxillofacial Surgeons. Osteoarthrosis was diagnosed arthroscopically in 30 joints (71%), 21 of which (70%) had more pronounced changes. Synovitis, mainly of a mild, localized type, was diagnosed in 39 joints (93%). More pronounced synovitis was found arthroscopically in 12 (31%). Adhesions were found in 20 joints (48%) and were significantly correlated with joints displaying osteoarthrosis (P < 0.001). The overall success rate for arthroscopic lysis and lavage was 50% (21/42 joints). The best response to lysis and lavage was in joints with arthroscopic diagnosis of pronounced synovitis (8/12 joints; 67%). All 21 joints regarded as unsuccessful were operated with diskectomy without implants. The success rate at 1-year follow-up was 18 joints (86%).
这项前瞻性1年随访研究了颞下颌关节松解和灌洗术相对于关节镜诊断的疗效。该研究纳入了42例患者。在手术前及术后定期进行临床评估，直至术后1年。所有患者均在局部麻醉下进行诊断性关节镜检查及随后立即进行的松解和灌洗。仅进行单侧上腔关节镜检查。根据美国口腔颌面外科医师协会1984年的标准对结果进行评估。关节镜诊断为骨关节炎的有30个关节（71%），其中21个（70%）有更明显的改变。诊断为滑膜炎的有39个关节（93%），主要为轻度、局限性滑膜炎。关节镜检查发现更明显滑膜炎的有12个（31%）。发现粘连的有20个关节（48%），且与显示骨关节炎的关节显著相关（P<0.001）。关节镜松解和灌洗的总体成功率为50%（21/42个关节）。对松解和灌洗反应最佳的是关节镜诊断为明显滑膜炎的关节（8/12个关节；67%）。所有21个被视为手术失败的关节均进行了无植入物的盘状切除术。1年随访时的成功率为18个关节（86%）。
