By the way, arthroscopy by itself, was used simple as a diagnostic tool - to go into the tissues with a small camera and see what is happening inside; nowadays, it seems it is more focused on arthroscopic surgery, but I suppose one can get a simple arthroscopy for investigatory purposes.
http://books.google.com/books?id=x6ThiifBP
csC&lpg=PA381&dq=arthroscopy tmj
&client=firefox-a&pg=PA381
Another book I found:
"Treatment
Clinical experiences shows that most patients have a resolution of their symptoms with simple, reversible treatments. Tollar reported that 51 % of patients with TMJ osteoarthritis were pain-free after 1 year, 76% after 2 years; and 98% after 5 years. The treatment of internal derangement and osteoarthritis initially is similar to that for myofascial pain. A careful explanation of the problem emphasizing its self-limiting nature should be given to the patient. Home care should include a soft diet, jaw rest, and application of moist heat. Medical therapy is directed at pain relief and reduction of inflammation by the of is nonsteroidal antiinflammatory medications. Narcotic analgesics should be avoided... (yeah, really?) Low-dose tricyclic antidepressants may be helpful if the patient is experiencing sleep disturbance. Dental treatment involves the use of occlusal appliances. While the physiologic basic for the effective of occlusal appliances IS POORLY UNDERSTOOD, they seem to reduce pain in 70 to 80% of patients.
TMJ surgery plays an important but limited role in treatment of patients whose symptoms are severe and refractory to conservative treatment. TMJ arthocentesis and joint lavage have been shown to be effective in managing cases with severe limitation of opening. The procedure is simple to perform and has no associated significant morbidity. TMJ ARTHROSCOPY HAS REVOLUTIONIZED THE SURGICAL APPROACH TO THE TREATMENT OF INTERNAL DERANGEMENT AND OSTEOARTHRITIS OF THE TMJ. ARTHROSCOPIC LAVAGE AND LYSIS OF ADHESIONS HAS PROVEN EFFECTIVE IN REDUCTION OF PAIN AND INCREASING RANGE OF MOTION IN APPROXIMATELY 80% OF PATIENTS TREATED. COMPLICATIONS WITH TMJ ARTHROSCOPY ARE LESS COMMON THAN WITH OPEN SURGERY. ADVANCED ARTHROSCOPIC OPERATIVE TECHNIQUES UTILIZING ROTORARY INSTRUMENTS, ELECTROCAUTERY. AND LASERS ARE BEING DEVELOPED, BUT THERE EFFECTIVENESS COMPARED WITH SIMPLE LAVAGE AND LYSIS OF ADHESIONS HAS NOT BEEN PROVEN. TMJ arthrOtomy procedures, including disc repositioning and arhroplasty or disectomy (menisceectomy), have been used for treating severe symptoms for many years and are successful in reducing symptoms in about 80% of patients. TMJ arthrotomy procedures are indicated for patients who have severe mechanical problems such as intermittent locking or severe mechanical problems such as intermittent locking or patients who previously have undergone surgery. COMPLICATIONS ASSOCIATED WITH TMJ ARTHROTOMY INCLUDE FACIAL NERVE INJURY, MALOCCLUSION, AND CONTINUED OR INCREASED SYMPTOMS. In past ten years, the yes of alloplastic implants in the TMJ was popular; however, experience has shown that most of these patients developed articulation of the implant and foreign-body reactions. Therefore the use of alloplastic implants in the TMJ is not recommended.
In summary, TMJ surgical procedures benefit about 80% of the patients treated. Unfortunately, about 5% of patients who undergo surgery experience a worsening of their symptoms. The decision to proceed with surgery must be carefully considered and made by both the patient and surgeon.
Courtesy of google books -
http://books.google.com/books?id=FinMDEN_i
DIC&lpg=PA83&dq=arthroscopy tmj&
amp;client=firefox-a&pg=PA84
Clinical primer of rheumatology (2002 )
By William J. Koopman, Dennis W. Boulware, Gustavo R. Heudebert
2002 book I would argue is abit outdated, but it's the one I came upon. Further research might yield more recent publications on this topic...
This reminds me of a visit with rheumatolgist who said I was fine, without even looking at the TMJ MRI. I insisted on the return of my money as her secretary assured me that doctor is familiar with TMJ disorders.. Unfortunately, few rheumatologist have experience in TMD cases and all they can due is shrug shoulders, or if they obey standard of care, contact oral surgeon for consultation.
