Is Arthroscopic disk repositioning equally efficacious to open disk repositioning? A Systematic Review.

Abstract Purpose Temporomandibular joint disc repositioning surgery is 1 of the treatment modalities used for treating anterior disc displacement (ADR) of the temporomandibular joint (TMJ). The procedure can be arthroscopic disc repositioning (ADR) or open disc repositioning (ODR). This systematic review measured and compared the efficacy of arthroscopic and open disc repositioning procedures. Materials and Methods The authors conducted a systematic review without meta-analysis by performing a literature search electronically and manually covering arthroscopic and open disc repositioning studies published up to July 2020 in Pubmed, Embase and Cochrane databases. Surgical outcomes such as changes in MIO and pain scores, TMJ noises, diet consistency, malocclusion and postoperative complications were extracted and analyzed. Results A total of 28 studies were included in the review and split into those assessing open disc repositioning (n = 13) and those assessing arthroscopic disc repositioning (n= 15). The average age of the study subjects in the included studies was 31.5 ± 6.8 and women represented 83.3% of the study population. Both Arthroscopic and open disc repositioning showed to be efficacious in reducing pain and increasing MIO Due to heterogeneity in study designs and data reporting between the studies, no quantitative analysis was performed and the groups were not directly compared. Conclusions Both arthroscopic and open disc repositioning led to significant improvements in clinical outcomes based on pain scores and MIO. This study highlights the need for comparative studies of the 2 techniques with well-documented case selection including standardized diagnosis based on Wilkes stages, and rigorous outcomes assessment including patient reported outcomes.