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A temporomandibular joint (TMJ) arthroscopy is a diagnostic and therapeutic operation, usually used when non-surgical treatment has failed to help a TMJ disorder, or additional advanced diagnostic techniques are necessary. As the procedure is done via keyhole, there is no need for any large cuts or scarring to your face.
An arthroscopy allows us to see inside your jaw joint without the need for a large cut. The tiny arthroscope camera is inserted into your joint to provide a more detailed look, and in some cases the problem can be treated at the same time.
There are three levels of arthroscopy, and the one used depends on the complexity of your case.
This is a basic diagnostic and therapeutic procedure. It can be used to assess the degree of cartilage damage, inflammation and even disc perforation to accurately plan future management and treatment. We can irrigate the joint under pressure and even use injections to the joint. You will need to carry out some jaw movement exercises after the procedure.
This involves an additional small incision, using a technique called triangulation. The procedure takes a little longer, but it allows for the use of coblation to remove problematic or unhealthy tissues without damage to the surrounding area. A biopsy is also possible with this technique and medication can be delivered directly into the joint. The recovery time can be a little longer and it may be slightly more painful afterwards.
Luke Cascarini is proud to have been the first surgeon in the UK to carry out a level III jaw arthroscopy. This is used to treat jaw joint disc displacement, able to relieve a clicking jaw joint, restricted movement and pain without the need for open surgery. As a result, patients experience fewer complications, reduced scarring and a quicker recovery.
A level III arthroscopy involves three small incisions, and is often combined with laser therapy or coblation to allow the disc to be reduced and arthroscopically stitched. This procedure takes a little longer and is technically very challenging, but can give a life-changing outcome. It is still completed as a day case, but three weeks of limited movement exercises are required afterwards.
Before an arthroscopy, you will likely have had other medical or non-surgical treatment to attempt to treat your TMJ disorder and relieve your symptoms. If these haven’t worked for any reason, we will discuss a TMJ arthroscopy with you as the next stage, giving you the chance to ask any questions.
During treatment, we insert the tiny 1.9mm arthroscope into your jaw joint while you are under general anaesthetic and your muscles are completely relaxed. A small cut is made in front of your ear for this, enabling us to use the camera to look for damage to your jaw joint.
If necessary for your case, arthroscopy can be used in combination with arthrocentesis, a type of joint wash to break down any loose material or inflammatory particles that may be damaging the joint.
Jaw joint arthroscopy is considered a minor surgical procedure, and you can go home to recover on the same day.
After you have had a TMJ arthroscopy, you should expect to experience swelling, discomfort, bruising and some bleeding. These are temporary and should fade within a few days to weeks.
As with any surgical operation, TMJ arthroscopy does come with some rare but significant risks. These include a less than 1% chance of injury to one of the small branches of the facial nerve, which could lead to some partial weakness on one side of your face. The risks are rare, and we make sure to discuss them with you before the procedure.
The jaw joint arthroscopy procedure itself is not painful, as you will be under general anaesthetic and won’t be able to feel a thing. After the arthroscopy, you will experience some pain, but you will be given medication to control this, reduce your discomfort and prevent headaches.
A TMJ arthroscopy is considered a minor surgical procedure and completed as a day case. After a short recovery period in hospital, you should be able to go home on the same day. We will give you some advice based on your individual case to aid your recovery, and you can contact the clinic or the hospital if you are worried about anything.
Rest is essential for recovery. It is vital to follow your recovery instruction to ensure a swift return to normal activities. Your surgeon will provide a personalised recovery plan based on your specific procedure, which many include exercises or physiotherapy.
The following day after leaving the hospital, you will be contacted by the clinical nurse specialist to ensure you understand your recovery plan. You will then have a follow-up appointment in the clinic 2-3 weeks after your TMJ arthroscopy. We will assess how well your jaw is opening and ask you whether you have seen a reduction in any symptoms. If the arthroscopy revealed a problem that was not able to be treated during the procedure, the possibility of further surgery will be discussed.
After your arthroscopy procedure, you will be advised which foods you should consume whilst you recover. This will usually include a soft food diet. During your follow-up appointment in the clinic, your case will be assessed, and we will let you know when you will be able to return to a normal diet once more.
If you would like to discuss treatment, book a consultation or just have a general enquiry, please get in touch.
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