Jungsuk Cho1, Howard Israel2. 1. PGY3 Resident, Department of Surgery, Division of Oral and Maxillofacial Surgery and Dentistry, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY. Electronic address: juc9079@nyp.org. 2. Professor of Clinical Surgery and Attending Oral and Maxillofacial Surgeon, Department of Surgery, Division of Oral and Maxillofacial Surgery and Dentistry, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY.
Abstract
PURPOSE: Although temporomandibular joint (TMJ) disorders encompass all age groups, it is generally considered to affect young to middle-age adults. The aim of this investigation was to study patients who met the criteria for TMJ arthroscopy and to determine whether there was a difference in outcomes between younger and older patients. MATERIALS AND METHODS: This was a retrospective chart review of patients who underwent TMJ operative arthroscopy. The primary variable studied was patient age. Major outcome variables included changes in subjective pain measured by a visual analog scale (VAS) and changes in maximum interincisal opening (MIO) after arthroscopic surgery. Other variables of interest included the presence of systemic disease, synovitis, and osteoarthritis diagnosed arthroscopically. Data analysis included the Student t test, regression analysis (R Studio, Boston, MA), and χ2 test with a P value less than .05 indicating statistical significance. RESULTS: The study population consisted of 103 patients diagnosed with internal derangement and severe inflammatory or degenerative TMJ disease (Wilkes stages II to V) who underwent operative arthroscopy. Patients were divided into 2 groups based on age (group Y, <40 yr old, n = 51, mean age, 26 yr; group O, >40 yr old, n = 52, mean age, 56 yr). The presence of osteoarthritis diagnosed arthroscopically was significantly greater in group O than in group Y (P < .01). There was significant postoperative improvement in pain (VAS) and MIO in group Y (P < .01) and group O (P < .01). Although the 2 groups showed substantial improvement after arthroscopy, when comparing differences in outcomes between the groups, the absolute postoperative pain level for group O was significantly lower than for group Y (P < .05). Comparison of postoperative MIO did not show a significant difference between group Y and group O (P = .286). CONCLUSIONS: Groups Y and O showed substantial improvement in pain (VAS) and mandibular mobility (MIO) after surgical TMJ arthroscopy. Group O had a higher prevalence of arthroscopically diagnosed osteoarthritis and lower postoperative pain levels compared with group Y. Older patients with advanced TMJ disease responded well to TMJ arthroscopy.
PURPOSE: Although temporomandibular joint (TMJ) disorders encompass all age groups, it is generally considered to affect young to middle-age adults. The aim of this investigation was to study patients who met the criteria for TMJ arthroscopy and to determine whether there was a difference in outcomes between younger and older patients. MATERIALS AND METHODS: This was a retrospective chart review of patients who underwent TMJ operative arthroscopy. The primary variable studied was patient age. Major outcome variables included changes in subjective pain measured by a visual analog scale (VAS) and changes in maximum interincisal opening (MIO) after arthroscopic surgery. Other variables of interest included the presence of systemic disease, synovitis, and osteoarthritis diagnosed arthroscopically. Data analysis included the Student t test, regression analysis (R Studio, Boston, MA), and χ2 test with a P value less than .05 indicating statistical significance. RESULTS: The study population consisted of 103 patients diagnosed with internal derangement and severe inflammatory or degenerative TMJ disease (Wilkes stages II to V) who underwent operative arthroscopy. Patients were divided into 2 groups based on age (group Y, <40 yr old, n = 51, mean age, 26 yr; group O, >40 yr old, n = 52, mean age, 56 yr). The presence of osteoarthritis diagnosed arthroscopically was significantly greater in group O than in group Y (P < .01). There was significant postoperative improvement in pain (VAS) and MIO in group Y (P < .01) and group O (P < .01). Although the 2 groups showed substantial improvement after arthroscopy, when comparing differences in outcomes between the groups, the absolute postoperative pain level for group O was significantly lower than for group Y (P < .05). Comparison of postoperative MIO did not show a significant difference between group Y and group O (P = .286). CONCLUSIONS: Groups Y and O showed substantial improvement in pain (VAS) and mandibular mobility (MIO) after surgical TMJ arthroscopy. Group O had a higher prevalence of arthroscopically diagnosed osteoarthritis and lower postoperative pain levels compared with group Y. Older patients with advanced TMJ disease responded well to TMJ arthroscopy.