Long-term evaluation of meniscectomy of the temporomandibular joint.

Meniscectomy for treatment of pain and dysfunction of the temporomandibular joint is a controversial operation because of the possible late complications of limitation of movement and pain. Therefore, the long-term results of this operation were clinically and radiologically investigated in a sample of 15 patients that had had meniscectomies performed during the period from 1947-1960 (mean follow up, 29 years). On clinical examination, all patients were free of pain, none had subjectively experienced dysfunction, and all but one could open their mouths more than 39 mm. Two thirds of the operated joints were crepitant. Radiologically all joints showed structural hard-tissue changes, mainly the presence of osteophytes and flattening of the condyle and tubercle. Absence of joint space was seen in half of the joints. The results indicate that meniscectomy relieves joint pain and eliminates subjectively perceived dysfunction in the long term despite the presence of clinical and radiologic signs of degenerative joint disease; however, as the condition of many patients who have temporomandibular joint disorders improves over time without surgery, there is a need for a controlled study on the value of meniscectomy.