Intraoperative complications in temporomandibular joint arthroscopy: A retrospective observational analysis of 899 arthroscopies |
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| Institution: | 1. Oral and Maxillofacial Surgeon, Hospital Universitario La Samaritana, Bogotá, Colombia;2. Department of Oral Research, Institución Universitaria Colegios de Colombia, Bogotá, Colombia;3. Oral and Maxillofacial Service, Hospital Universitario Fundación Santa Fe de Bogotá, Colombia;4. Oral and Maxillofacial Surgery Program, Universidad El Bosque, Bogotá, Colombia;5. Unit of Basic Oral Investigation (UIBO), Facultad de Odontología, Universidad El Bosque, Bogotá, Colombia;6. Department of Oral and Maxillofacial Surgery, Hospital Clínico San Carlos, Madrid, Spain;1. Univ. Lille, CHU Lille, Service de Chirurgie Maxillo-Faciale et Stomatologie, F-59000, Lille, France;2. Univ. Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008;3. Controlled Drug Delivery Systems and Biomaterials, F-59000, Lille, France;4. Ramsay Générale de Santé, Hôpital Privé Arras Les Bonnettes, Arras, France;1. Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan;2. Joint Research Department of Next-Generation Dental Materials Engineering, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan;3. Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan;1. A.R.M. Center of Otolaryngology Head and Neck Surgery, Assuta Medical Centers, Tel Aviv, Israel. Affiliated with Ben-Gurion University of the Negev, Israel;2. Department of Academy and Research, Assuta Medical Centers, Tel Aviv, Israel |
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| Abstract: | This study aims to describe intraoperative complications in temporomandibular joint arthroscopy in patients with Wilkes stage II, III y IV. An analytic observational retrospective study. Inclusion criteria were patients who had no improvement with conservative treatment diagnosed as Wilkes II stage to Wilkes stage IV, and no previous TMJ surgery. Exclusion criteria were disc perforation observed by arthroscopy. Data collected from 458 patients (899 arthroscopies). Of this population, 772 (85.8%) arthroscopies correspond to women, and 127 men (14.1%). Of the sample evaluated, 368 (40.9%) were arthroscopic without discopexy, and 531 (59%) were arthroscopic with discopexy using resorbable pins. In total, 330 complications (36.7%) were found, of which 293 (32.5%) were implicated with iatrogenic damage to the anatomy, and 36 (4%) were associated with some instrument failure. Of this total number of complications, 191 (51.9%) of 386 corresponded to the arthroscopy without discopexy group and 138 (25.9%) of 531 corresponded to the arthroscopy with discopexy group. These study data suggest that the main complications were irrigation fluid extravasation (p = 0.000), and intra-articular bleeding (p = 0.001) followed by pin problems (p = 0.001) in cases of arthroscopies with discopexy. Within the limitations of the study it seems that the learning curve has an important influence on the occurrence of complications. At the beginning of the learning curve, complications are more related to anatomy. Afterwards, the rate of complications decreases but they are more related to the instruments used in advanced techniques. Therefore, proper training and a wide learning curve can reduce the risk of complications and if any occur, more timely management could be given. |
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| Keywords: | TMJ arthroscopy TMJ discopexy Complications Arthroscopy Temporomandibular joint |
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