Arthroscopic management of septic arthritis of temporomandibular joint
Received 16 February 2009; received in revised form 28 July 2009; accepted 5 August 2009.
This article reports on 7 patients with septic arthritis of the temporomandibular joint (TMJ) who were managed with arthroscopy between 1998 and 2007. The common symptoms were trismus and pain. A series of imaging studies showed widening of joint space in 1 patient with plain film; MRI demonstrated increased joint effusion in 4 patients; accompanying cellulitis in adjacent tissues was discerned by CT in 2 patients. Under the arthroscope, a reddened and swollen synovial membrane was found in 2 patients who were in the acute stage, whereas strong adhesions, destruction of cartilage, and bony defects were discovered in other 5 patients in the chronic stage. Additionally, the disc was ruptured in 3 patients, and fibrosis was confirmed for 2 patients. Lavage, lysis of adhesion, and debridement of articular surface were common procedures for treatments. The average follow-up period was 57.4 months, and no recurrence was found. Arthroscopy has proven to be a useful method for management of septic arthritis of TMJ, especially for patients in the chronic stage.
aAssociate Professor, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
bProfessor, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
cLecturer, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
dNurse, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
Reprint requests: Chi Yang, PhD, Department of Oral & Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, P.R. China
This project was supported by grants from the Science and Technology Commission of Shanghai (08DZ2271100) and Shanghai Municipal Health Bureau Fund (2007008).
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