Date: Dec 2023

Oral & Maxillofacial Surgery - Temporomandibular Joint Arthroscopy: Information for patients

Introduction

This leaflet includes information for those who have been recommended by an Oral and Maxillofacial surgeon to have a Temporomandibular (jaw) Joint (TMJ) arthroscopy. Inside you will find what a TMJ arthroscopy is, why you need it, what will happen on the day of the surgery and what to do afterwards. Please speak to your surgeon or nurse in the Oral and Maxillofacial surgery department if you have any questions or need advice.

What is a TMJ arthroscopy?

Arthroscopy is inspection of a joint using a camera. This procedure is keyhole surgery for inspecting the inside of jaw joint using a camera. This enables the surgeon to see problems such as damage to the joint or loose material needing to be washed out. It is usually carried out while the patient is asleep under a general anaesthetic.

Why do I need a TMJ arthroscopy?

TMJ arthroscopy is used to diagnose or confirm a problem you might have with your joint. It may help to reduce the pain and improve function by washing the joint out. This is called Arthrocentesis.

What happens during the surgery?

The arthroscopy is usually done under General Anaesthetic while you are fully asleep. In most cases the procedure itself takes twenty to thirty minutes for each joint. This can be longer depending on the treatment needed. You would usually be in theatre and recovery unit for two to three hours in total.

A small needle entry or cut is made in front of your ear which the camera will be inserted into. Another one or two needles will be put beside the cut to act as an outlet for the water if a washout of the joint is needed. Inspection of the joint takes place using the camera. Sometimes the lower jaw is moved around or manipulated to allow good view of cartilage and joint space. This also can help repositioning the joint disc to go back in its usual position.

A sterile plaster or a small stich will be placed over the small cut to allow it to heal.

What happens after the surgery?

You would be given something to eat and drink once deemed suitable. Usually you will be discharged home the same day. In some cases, you might need to stay in hospital overnight.

After discharge

After having a general anaesthetic, you will not be able to drive, work, operate heavy machinery or sign legal documents for 48 hours. You will also need someone to be with you for 24 hours after the anaesthetic.

You can eat and drink straight away, but it is better to maintain a soft diet for the first 5 days. This can be increased to normal diet and function by day 7 to exercise the joint. You can take over the counter pain relief, such as Paracetamol or Ibuprofen, as you need it.

Mouth opening exercises may be recommended by your surgeon.

General risks and side effects include:

Like other surgical procedures, there are some risks involved with arthroscopy.

• Pain
• Bruising
• Swelling
• Infection
• Bleeding
• Blood clots

Specific risks and side effects

You may experience numbness to your face because the nerve that supplies your face can be affected. There is a small risk to your facial nerve and the ear canal next to the joint. These are usually temporary and resolve without intervention. There is a very small chance it can be permanent.

Your jaw can be stiff making it difficult to open your mouth, which will subside after a few days.

Authors: Ghaly A Ghaly, Barbara Gerber, Athanasios Kalantzis