Temporomandibular joint arthroscopic findings in patients with cervical flexion-extension injury (whiplash): a preliminary study of 30 patients.

PURPOSE To investigate arthroscopic findings for the temporomandibular joint (TMJ) in 30 patients with refractory TMJ symptoms who had suffered cervical flexion-extension injury (whiplash). METHODS The clinical data and operative reports of all patients with a diagnosis of TMJ whiplash injury who underwent TMJ arthroscopic procedures from 1997 to 2002 were reviewed. All patients underwent preoperative clinical, panoramic, arthrographic, magnetic resonance imaging evaluation or computed tomography (or some combination). The same surgical team performed all diagnostic and therapeutic arthroscopic procedures in patients for whom conservative therapy had failed. Before the arthroscopic surgery, all of the patients had received at least 3 to 6 months of nonsurgical therapy consisting of anti-inflammatory medications, muscle relaxants, splint therapy, physiotherapy (specifically transcutaneous electrical nerve stimulation, moist heat, cold laser, and ultrasonography) and a soft diet. RESULTS A spectrum of arthroscopic findings, ranging from chondromalacia (softening of the articular fibrocartilage) to moderate or severe synovitis and adhesions, was observed, as well as combinations of these abnormalities. CONCLUSION The primary intracapsular pathologic changes observed during TMJ arthroscopic examination of 30 patients who suffered cervical whiplash injury appear to be nonspecific, varying along a wide spectrum of findings.