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High condylar shave with meniscorhaphy in the treatment of internal derangement of temporomandibular joint. Clinical, radiographic, and patient-based outcomes.

Purpose: the aim of this study was to evaluate clinical, radiographic and patient-based outcomes of high condylar shave with meniscorhaphy in the treatment of internal derangement of temporomandibular joint Patients and methods: Seven patients (5 females and 2 males) with unilateral internal derangement of the temporomandibular joint (TMJ) who did not respond to previous conservative treatment was included in this study. High condylar shave surgery with meniscorhaphy was performed to all participants. Clinical outcomes (Maximum mouth opening, deviation toward affected joint, extent of lateral excursion, TMJ tenderness, and joint sound), and patient-based outcomes (degree of pain, pain effect on life) were evaluated before surgery, 6 months and one year after surgery. MRI outcomes (Position and morphology of the meniscus, and synovial fluid effusion) were evaluated before surgery and one year after surgery. Results: Maximum mouth opening, and lateral movements significantly increased after six months and one year compared to preoperative measurement. Deviation towards the affected joint, TMJ tenderness, joint sounds significantly decreased after six months and one year compared to preoperative measurement. However, there was no significant difference in these outcomes between six months and one year. Disc position and morphology significantly improved, and synovial fluid effusion significantly reduced after one year compared to preoperative measurements. Mean degree of Pain and effect of pain on life significantly decreased at 6 months and one year compared to preoperative measurements. Mean degree of pain decreased significantly from 6 months to one year. However, pain effect on life did not differ significantly between 6 months and one year. Conclusion: Within the limitation of this study, high condylar shave with meniscorhaphy in an effective treatment of internal derangement of TMJ in cases which did not respond to conservative treatment as it improved clinical, radiographic, and patient-based outcomes. (282) Hosam E. Said E.D.J. Vol. 68, No. 1