TMJ Arthrocentesis

What is TMJ Arthrocentesis?

Sometimes conservative therapy (splints, medications, physical therapy) doesn't work and you need to take the next step. Enter TMJ Arthrocentesis. Arthrocentesis is the process of clearing the joint of inflammation. There are certain inflammatory enzymes and pain mediators that build up in the TMJ joint space. These pain mediators and inflammation cause discomfort as they accumulate. TMJ Arthrocentesis removes these factors and gives the joint a fresh start. Arthrocentesis can also remove mild scarring and fibrous bands that may be causing joint noises and limitation in movement.

TMJ Arthrocentesis is effective in relieving pain in 70% of people who didn't respond to conservative treatment

What is the procedure like?

Arthrocentesis is a simple procedure. It is very safe and has few downsides. The process is usually started with light sedation and local anesthesia so the procedure is painless. The procedure is done by inserting two small needles into the joint space. One needle is used to push fluid into the joint and the other for letting fluid out of the joint. Studies show that 120mL of fluid is needed to remove all the chemical factors that cause pain and inflammation. After this fluid is flushed through the joint, usually a steroid, lubricant or pain medicine is placed in the joint. 

What is the recovery like?

After the procedure you will not feel any pain. This is because local anesthesia is placed around the joint for a smooth and painless procedure. When this wears off after a couple hours you will likely feel some pressure around the joint. It is not uncommon to have a small amount of the fluid seep into the area in front of the ear causing some swelling that goes away quickly. A couple days of a narcotic or NSAID's are given post operatively for pain control.

What if it doesn't work?

TMJ arthrocentesis works in about 70% of those that don't respond to conservative therapy. For those who don't respond favorably to TMJ arthrocentesis, they are candidates for TMJ arthroscopy. This is a procedure much like arthrocentesis except a tiny camera is placed in the joint as well to visually see what is going on in the joint as well as replace the disk to where it should be, effectively removing bone on bone contact and oftentimes eliminating pops and clicks.