SURGICAL ASPECTS OF TREATING TEMPOROMANDIBULAR JOINT DISORDERS: ARTHROCENTESIS AND ARTHROSCOPY AS METHODS OF CHOICE

Rochshin Evgeny Myhailovych

The article presents the results of a study on the surgical treatment of temporomandibular joint (TMJ) disorders using arthrocentesis and arthroscopy. The relevance of the work is determined by the high prevalence of TMJ dysfunctions leading to chronic pain syndrome and reduced quality of life in patients. The authors emphasize the limited effectiveness of conservative methods and justify the necessity of minimally invasive surgical interventions to address structural abnormalities. Ninety-nine patients with TMJ dysfunction participated in the study, divided into groups according to the severity of their pathology. Criteria for selecting the method (arthrocentesis or arthroscopy) included duration of pain syndrome, levels of inflammatory markers (e.g., C-reactive protein), presence of intra-articular effusion, and the extent of morphological changes confirmed by MRI and CT. Arthrocentesis was applied in mild forms with predominant exudative processes, while arthroscopy was used for adhesive processes and joint instability. The results demonstrated statistically significant differences between the groups: patients who underwent arthroscopy had a longer pain history (19.23 months vs. 14.82 months), higher inflammatory marker levels (CRP: 12.01 mg/L vs. 9.37 mg/L), and a larger volume of joint effusion (2.31 mL vs. 1.56 mL; p < 0.05). Treatment success correlated with age: younger patients (18–35 years) regained joint mobility faster (3.78 days) and exhibited a greater reduction in pain (3.41 points on the visual analogue scale). Long-term follow-up confirmed the importance of comprehensive rehabilitation (physiotherapy, therapeutic exercise) in preventing relapses. The study’s conclusions emphasize that arthrocentesis and arthroscopy are complementary: the former is effective in early stages of inflammation, while the latter is indicated for structural changes. Key factors in choosing the treatment approach include pathology severity, patient age, and adherence to postoperative rehabilitation.

Keywords:temporomandibular joint, arthrocentesis, arthroscopy, surgical treatment, rehabilitation.