TMJ arthroscopy with hyaluronic acid: A 12‐month randomized clinical trial

Castaño‐Joaqui, Oscar Gabriel; Cano‐Sánchez, Jorge; Campo‐Trapero, Julián; Muñoz-Guerra, M.F.

doi:10.1111/odi.13524

Cited by 14 publications

(24 citation statements)

References 36 publications

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“…No differences were observed between the two groups in VAS pain score, maximum mouth opening, and disk position by MRI at months 3, 6, 9, and 12. 23 …”

Section: Resultsmentioning

confidence: 99%

The Current Status of Clinical Trials on Biologics for Cartilage Repair and Osteoarthritis Treatment: An Analysis of ClinicalTrials.gov Data

Zhang

Schon

2022

CARTILAGE

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Objective Biologics are increasingly used for cartilage repair and osteoarthritis (OA) treatment. This study aimed to provide an overview of the clinical trials conducted on this subject. Design Two-word combinations of two sets of key words “cartilage”; “joint”; “osteoarthritis” and “biologics”; “stem cells”; “cell implantation” were used to search the database of ClinicalTrials.gov and supplemented with searches of PubMed and EMbase. The registered trials were analyzed for clinical conditions, completion status, phases, and investigated biologics. Recently completed trials with posted/published results were summarized. Results From 2000 to 2022, a total of 365 clinical trials were registered at ClinicalTrials.gov to use biologics for cartilage repair and OA treatment. Since 2006, the number of registered trials accelerated at an annual rate of 16.4%. Of the 265 trials designated with a phase, 72% were early Phase 1, Phase 1, and Phase 2. Chondrocytes and platelet-rich plasma (PRP) were studied in nearly equal number of early- and late-stage trials. Mesenchymal stem/stromal cells (MSCs) were the most commonly investigated biologics (38%) and mostly derived from bone marrow and adipose tissue (70%). In last 5 years, 32 of the 72 completed trials posted/published results, among which seven Phase 3 trials investigated chondrocytes, PRP, bone marrow aspirate concentrate, hyaluronic acid, collagen membrane, and albumin. Conclusions There was a rapid increase in the number of registered clinical trials in recent years, using a variety of biologics for cartilage repair and OA treatment. Majority of the biologics still require late-stage trials to validate their clinical effectiveness.

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“…No differences were observed between the two groups in VAS pain score, maximum mouth opening, and disk position by MRI at months 3, 6, 9, and 12. 23 …”

Section: Resultsmentioning

confidence: 99%

The Current Status of Clinical Trials on Biologics for Cartilage Repair and Osteoarthritis Treatment: An Analysis of ClinicalTrials.gov Data

Zhang

Schon

2022

CARTILAGE

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“…Hyaluronic acid was injected during the arthroscopic procedure in four joints where there were signs of severe degenerative joint disease as it might have a positive effect on pain reduction [26]. However, a recent randomized controlled trial published in 2021 with 51 patients (Wilkes stage-III and stage-IV) observed no beneficial effect of hyaluronic acid on pain reduction compared to arthroscopy alone [27]. These new insights were not available at the time the arthroscopies were performed but are important to take into account when performing arthroscopies in the future.…”

Section: Discussionmentioning

confidence: 99%

Correlation of MRI and arthroscopic findings with clinical outcome in temporomandibular joint disorders: a retrospective cohort study

et al. 2022

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Background Arthroscopy is a minimally invasive diagnostic tool and treatment strategy in patients suffering from temporomandibular disorders (TMD) when conservative treatment fails. This study aimed to find specific variables on pre-operative MRI or during arthroscopy that could predict success of arthroscopic lysis and lavage. Methods This retrospective analysis compared pre-operative maximum interincisal opening (MIO), pain and main complaint (pain, limited MIO or joint sounds) with results at short-term and medium-term follow-up (ST and MT respectively). Different variables scored on MRI or arthroscopy were used to make a stepwise regression model, subsequently a combined analysis was conducted using variables from both MRI and arthroscopy. Results A total of 47 patients (50 joints) met the inclusion criteria. The main complaint improved by 62 and 53% at ST and MT respectively. The absolute or probable absence of a crumpled disc scored on MRI predicted success at ST and MT (p = 0.0112 and p = 0.0054), and remained significant at MT in the combined analysis (p = 0.0078). Arthroscopic findings of degenerative joint disease predicted success at ST (p = 0.0178), absolute or probable absence of discal reduction scored during arthroscopy significantly predicted success in the combined analysis at ST (p = 0.0474). Conclusion To improve selection criteria for patients undergoing an arthroscopic lysis and lavage of the TMJ, future research might focus on variables visualized on MRI. Although more research is needed, disc shape and in particular the absolute or probable absence of a crumpled disc might be used as predictive variable for success.

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“…The outcome of arthroscopy was correlated to that of arthroscopy followed by an injection of plasma rich in growth factors (PRGF) in a total of four articles, where all of them were of low or medium risk of bias. 35,36,67,71 However, Castano-Joaqui et al had not included the post-operative values of MIO or TMJ pain and were therefore not included. 67 Leketas et al were only presenting the MIO mean value at 1-week post-operative and were therefore disregarded in the MIO analysis.…”

Section: Arthroscopy Versus Arthroscopy and Prgfmentioning

confidence: 99%

“…35,36,67,71 However, Castano-Joaqui et al had not included the post-operative values of MIO or TMJ pain and were therefore not included. 67 Leketas et al were only presenting the MIO mean value at 1-week post-operative and were therefore disregarded in the MIO analysis. 71 Neither MIO, nor TMJ pain differed between the two treatment groups in a significant way (MIO: MD 0.95, 95% CI −0.36 to 2.25; TMJ pain: MD −0.39, 95% CI −0.95 to 0.17)…”

Section: Arthroscopy Versus Arthroscopy and Prgfmentioning

confidence: 99%

“…Three articles comparing arthroscopy to arthroscopy with injection of HA at the end of the arthroscopic procedure were found. 36,67,71 Two articles displayed variable values that could be used in the metaanalysis. 36,71 It should be noted that the arthroscopic procedure alone in this analysis were represented by arthroscopy and PRGF injection in Fernandez-Ferro et al and a merging of the patient cohort treated with arthroscopy and the cohort treated with arthroscopy and PRGF injection in Leketas et al 36,71 TMJ pain but not MIO was possible to analyse and no significant difference in TMJ pain were seen (MD −0.66, 95% CI −3.40 to 2.09) (Figure S4).…”

Section: Arthroscopy Versus Arthroscopy and Hyaluronic Acidmentioning

confidence: 99%

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Evidence for minimally invasive treatment—A systematic review on surgical management of disc displacement

Ulmner,

Bjørnland,

Rosén

et al. 2024

J of Oral Rehabilitation

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BackgroundSurgical treatment of temporomandibular joint (TMJ) disc displacement (DD) has been established in different forms since over a century. Ther is a consensus to perform minimal invasive interventions as first‐line surgical treatment since there are no evidence on best surgical practice yet.ObjectiveThe aim was to perform a complex systematic review (SR) on the topic—is there evidence for surgical treatment of TMJ DD?MethodsThe PICO was defined as DD patients (population), treated with different surgical interventions including arthrocentesis (intervention), compared with other or no treatment (control) regarding the outcome variables mandibular function, mouth opening capacity, TMJ pain, etcetera (outcome). For identification of prospective controlled trials and SRs, a search strategy was developed for application in three databases.ResultsThe search yielded 4931 studies of which 56 fulfilled the stipulated PICO. Studies with low or moderate risk of bias were possible to include in meta‐analyses. There were evidence suggesting arthrocentesis being more effective compared to conservative management (maximum interincisal opening (MIO): p < .0001, I2 = 22%; TMJ pain: p = .0003, I2 = 84%) and arthrocentesis being slightly more effective than arthrocentesis with an adjunctive hyaluronic acid injection (MIO: p = .04, I2 = 0%; TMJ pain: p = .28, I2 = 0%). Other treatment comparisons showed nonsignificant differences. The performed meta‐analyses only included 2–4 studies each, which might indicate a low grade of evidence.ConclusionAlthough arthrocentesis performed better than conservative management the findings should be interpreted cautiously, and non‐invasive management considered as primary measure. Still, several knowledge gaps concerning surgical methods of choice remains.

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TMJ arthroscopy with hyaluronic acid: A 12‐month randomized clinical trial

Cited by 14 publications

References 36 publications

The Current Status of Clinical Trials on Biologics for Cartilage Repair and Osteoarthritis Treatment: An Analysis of ClinicalTrials.gov Data

The Current Status of Clinical Trials on Biologics for Cartilage Repair and Osteoarthritis Treatment: An Analysis of ClinicalTrials.gov Data

Correlation of MRI and arthroscopic findings with clinical outcome in temporomandibular joint disorders: a retrospective cohort study

Evidence for minimally invasive treatment—A systematic review on surgical management of disc displacement

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