The arthroscopy is more involved and invasive than TMJ arthrocentesis. This procedure is almost always done in the outpatient facilities (or day surgery) at the hospital. A small scope (camera) is used to take a look inside the temporomandibular joint. Some surgeons will not only look inside, but may perform other procedures like suturing the discs in place, or removing loose scar tissue.
Day of Surgery
You will check in prior to your surgery time and an IV will be started. The anesthesiologist will visit and take a look at your opening, you will be asked several times about your procedure, and they will double check your information and ask about allergies. Before the surgery, the surgeon may come and visit to discuss what he will be doing and what you can expect when you you wake up. You have usually already had a pre-op appointment to discuss all of this information, so it is just to make sure you don’t have any additional questions. After this you may be given medication to help you relax, and then you are off to the operating room. When you wake up you will be in the recovery room. You might feel pain in your joints from the surgery. You also might have a pressure bandage on (we call it a jaw bra). Please let the nurses know if you are in pain, they are there to give you medication and make sure that you are comfortable. Nausea is common after general anesthesia as well, so if this is an issue for you, make sure to mention it to everyone prior to your surgery so they can give you the appropriate medication.
Recovery from TMJ Arthroscopy
Recovery time for an arthroscopy is usually a week or so, but it can vary widely. Your surgeon will advise you when you should return to work, because a lot depends on your occupation. You might also be told to maintain a soft diet, but chances are, you already are! You may also be encouraged to start physical therapy. When you go for your post-op appointment, your oral surgeon may show you photos from inside your joints as well.
There is very little, if any, scarring from an arthroscopy. The opening used to insert the instrument into the joint space is very small, so the resulting incision is usually less than 5mm long and uses only a few stitches. Sometimes, there is some bruising in the ear area.
Advantages & Disadvantages
As with all TMJ treatments and surgeries, there are advantages and disadvantages to arthroscopy. It does allow the surgeon to take a look inside the joint spaces and possibly remove scar tissue. For many patients, the recovery is shorter and easier than an open joint procedure and the scar is much smaller. However, this surgery is more expensive than arthrocentesis, takes longer, and requires general anesthesia, which carries more risk than IV sedation.
Since there is so little scientific research about TMJ disorder, invasive treatments like surgery continue to be controversial. At the very least, it is important for the patient to research the proposed treatment and get a second, independent opinion. The US National Institutes of Health encourage patients to try conservative, reversible treatments. They say that “less is best.”
Patients considering any type of TMJ procedures, including arthroscopy, are encouraged to research and become knowledgeable about their options before committing to a treatment that is not guaranteed to increase opening or relieve pain.
If you’d like help preparing for your TMJ surgery, read more about TMJ Hope’s private coaching.