Single-puncture arthrocentesis--introducing a new technique and a novel device.

F b rthrocentesis of the temporomandibular joint was ntroduced in 1991 by Nitzan et al and has since ained widespread popularity among practitioners ho treat temporomandibular joint disorders. It is onsidered by many as the first-line surgical treatment or patients who do not respond to conservative treatent (physical therapy, occlusal splint therapy, pain edication, and lifestyle and behavioral changes). It is egarded as a minimally invasive procedure and is asily performed in an office setting. It allows lavage f the joint space and lysis of adhesions via hydraulic istension. The traditional procedure uses 2 needles inserted hrough 2 separate puncture sites. These 2 needles ust triangulate and be exactly placed in the upper oint space for the procedure to be efficient. One of he needles serves for the inflow of the lavage olution and the second as the outflow. It is recogized that the procedure can be sometimes very hallenging. The blind insertion of the second (outow) needle can sometimes be difficult. Multiple unctures through the temporomandibular joint apsule are often necessary, which often leads to xtra-articular leak of the lavage solution and dereases the intra-articular pressure required for lysis f the adhesions. We have developed a new device where two 18auge needles 1.5 inches long are each bent 30 derees toward their respective opening and welded