Clinical analysis of the efficacy of arthroscopic irrigation combined with repositioning splint in the treatment of acute anterior disc displacement without reduction

HAO Wen-jie; ZHANG Xing-an; TAN Xiao-yao; MING Hua-wei; CHEN Fang-yuan; YUAN Zong-yi; HU Qi-sheng

doi:10.19538/j.kq.2025.01.008

Abstract：Objective To analyze the clinical effect of arthroscopic irrigation combined with repositioning splint in the treatment of acute anterior disc displacement without reduction(ADDWoR).Methods A total of 90 patients with acute ADDWoR who visited the Department of Oral and Maxillofacial Surgery of Nanchong Hospital Affiliated to Beijing An-zhen Hospital,Capital Medical University(Nanchong Central Hospital)from June 2022 to July 2024 were selected and randomly divided into the experimental group(46 patients,treated with arthroscopic irrigation combined with reposition-ing splint)and the control group(44 patients,treated with conventional puncture irrigation combined with repositioning splint)using a random number table.The visual analogue scale(VAS)score,maximum mouth opening(MMO)cranioman-dibular index(CMI),disc length,condylar height and in-terleukin-6(IL-6)concentration in synovial fluid before treatment and at 6 months after treatment were recorded.Complications at 6 months after treatment were also record-ed,and the therapeutic effects were evaluated.Results Before treatment,there were no statistically significant dif-ferences in VAS score,MMO,CMI,disc length,condylar height or IL-6 concentration between the two groups(all P＞0.05).Six months after treatment,MMO significantly increased,while VAS score,CMI and IL-6 concentration significant-ly decreased in both groups compared with before treatment,with more pronounced decrease in the experimental group.Ad-ditionally,disc length and condylar height significantly increased in the experimental group compared with before treatment(all P＜0.05).No related complications occurred in either group.The effective rate of treatment in the experimental group was 87.0％(40/46),significantly higher than that in the control group[72.7％(32/44)],with a statistically significant differ-ence(x2=6.219,P=0.045).Conclusion Arthroscopic irrigation combined with repositioning splint is an effective treat-ment for acute ADDWoR.It not only significantly improves the patient's subjective pain symptoms but also promotes the re-covery of condylar height,disc length and function.It is a safe,effective and minimally invasive novel treatment method.