Can arthrocentesis release intracapsular adhesions? Arthroscopic findings before and after irrigation under sufficient hydraulic pressure

Purpose: To investigate the effect of release of intra-articular adhesions of arthrocentesis, we examined patients with closed lock of the temporomandibular joint by arthroscopy before and after irrigation. Patients and Methods: In 6 closed lock cases in which adhesions in the upper joint space were observed by arthroscopy before arthrocentesis, arthroscopic examination was performed again to confirm whether the adhesion was released after the procedure. Range of mouth opening and joint pain were examined to determine the clinical efficiency of the procedure. Results: Adhesion was not released by irrigation under low pressure but could be released by irrigation under high pressure. After irrigation under low and high pressure, the maximum mouth opening of the patients improved from 0 to 1 mm (average, 0.3 mm) and 2 to 6 mm (average, 3.7 mm), respectively. Conclusions: The results indicate that arthrocentesis with sufficient pressure could be effective for closed lock cases with adhesions in the upper joint compartment. (C) 2003 American Association of Oral and Maxillofacial Surgeons.