Efficacy of Hyaluronic Acid Deposition Post TMJ Arthroscopy Versus Conventional TMJ Arthroscopy for Patients Suffering from Internal Derangement: A Clinical Study

Abstract

Aim: To evaluate and contrast the clinical efficacy of supplementary intra-articular hyaluronic acid (HA) administration following arthroscopic lysis and lavage (ALL) against ALL monotherapy in patients diagnosed with Stage III and IV temporomandibular joint internal derangement (TMJ-ID), according to Wilkes' classification.
Subjects and Methods: Twenty patients with TMJ-ID were randomized into two equal groups (n = 10): Group I (ALL + HA) and Group II (ALL alone). Pain intensity, maximum interincisal opening (MIO), lateral/protrusive movements, joint sounds, and bite force, were evaluated clinically and via MRI at baseline, immediately post-procedure, and at 6 months.
Results: While both therapeutic protocols yielded sustained pain alleviation throughout the 6-month period, the adjunctive HA cohort demonstrated significantly superior pain reduction in the early-to-mid postoperative phase alongside accelerated recovery in protrusive movement (p < 0.05). At the 6-month mark, both groups exhibited equivalent improvements in MIO, lateral mobility, bite force, and Radiographic evaluation via MRI demonstrated no statistically significant intergroup variations (p > 0.05) regarding articular disc position or joint structural integrity. Masticatory efficiency and joint sound abatement improved comparably across both arms.
Conclusion: Adjunctive HA after ALL enhances early postoperative pain relief and mobility recovery. However, given equivalent 6-month functional and structural outcomes, ALL alone remains an effective standard therapy for advanced TMJ-ID.