Relationship between the success of arthrocentesis and preoperative magnetic resonance imaging findings

Abstract

Aims: This study aimed to investigate the relationship between preoperative magnetic resonance imaging (MRI) findings and clinical outcomes following arthrocentesis in patients with temporomandibular joint disorders. Methods: A total of 67 patients who had been diagnosed with disc position abnormalities and degenerative temporomandibular joint conditions based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), had preoperative MRI scans, and were treated with arthrocentesis were included in the study. The recorded preoperative variables included age, sex, pain, and maximum mouth opening (MMO). Degree of disc displacement and joint effusion were assessed using preoperative magnetic resonance images. Bone changes were evaluated using both preoperative magnetic resonance and panoramic radiography images. Arthrocentesis was considered successful when the MMO exceeded 35 mm and the pain score was less than 3. Results: At the 1-week and 3-month follow-ups, clinical examinations showed a significant reduction in temporomandibular joint (TMJ) pain and an increase in MMO (p<0.001). The total success rate increased from 19.4% at the 1-week follow-up to 44.8% at 3 months, indicating a significant improvement over time. MRI findings, including disc displacement, effusion, and bone changes, showed no statistically significant association with treatment success. Although patients without effusion showed lower VAS scores at 1 week, this difference did not persist at 3 months. Conclusion: Arthrocentesis is a successful intervention for treating TMD, resulting in significant reductions in pain and functional limitation. However, commonly evaluated preoperative MRI features do not appear to predict clinical success.

Keywords

• Arthrocentesis
• magnetic resonance imaging
• temporomandibular disorder

Artrosentez başarısı ve preoperatif manyetik rezonans görüntüleme bulguları arasındaki ilişkinin değerlendirilmesi

Abstract

Amaç: Bu çalışma, temporomandibular eklem bozukluğu olan hastalarda preoperatif manyetik rezonans görüntüleme (MRG) bulguları ile artrosentez sonrası klinik sonuçlar arasındaki ilişkiyi araştırmayı amaçlamaktadır. Yöntem: Bu retrospektif çalışmaya DC/TMD kriterlerine göre disk deplasmanı (reduksiyonlu veya reduksiyonsuz) ve dejeneratif eklem hastalığı tanısı konulan, artrosentez uygulanmış ve preoperatif MRG’si bulunan 67 hasta dahil edilmiştir. Cinsiyet, yaş, ağrı şiddeti ve maksimum ağız açıklığı (MMO) işlem öncesi klinik değişkenler olarak kaydedildi. Preoperatif manyetik rezonans görüntüleri değerlendirilerek disk deplasman derecesi ve efüzyon derecesi belirlendi. Kemik değişikliği derecesi ise preoperatif manyetik rezonans ve panoramik radyografi görüntüleri değerlendirilerek belirlendi. Artrosentez işleminin başarısı için, 35 mm'den fazla MMO ve 3'ten düşük ağrı şiddeti kriter olarak belirlendi. Bulgular: Hastaların 1 haftalık ve 3 aylık takip sonuçları temporomandibular eklem (TME) ağrısında belirgin bir azalma ve MMO'da belirgin bir artış olduğunu gösterdi (P <0.001). Toplam başarı oranı 1. haftada %19.4 iken 3. ayda %44.8’e yükselmiştir. Disk deplasmanı, effüzyon ve kemik değişiklikleri ile tedavi başarısı arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır. Effüzyon olmayan hastalarda 1. haftada VAS skorları daha düşük olsa da, bu fark 3. ayda devam etmemiştir. Sonuç: Artrosentez, TMB tedavisinde etkili bir yöntemdir. Ancak sık değerlendirilen MRG bulgularının tedavi başarısını öngörme açısından sınırlı değeri olduğu görülmektedir.

Keywords

• artrosentez
• manyetik rezonans görüntüleme
• temporomandibular düzensizlik

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