Ultrasound-guided autologous blood injection in patients with chronic recurrent temporomandibular joint dislocation

OBJECTIVE: To evaluate the accuracy and effectiveness of ultrasound (US) guided autologous blood injection (ABI) for the treatment of chronic recurrent TMJ dislocation. DESIGN: Prospective cohort study. SETTING: Centre for medical education and research. PARTICIPANTS (OR ANIMALS, SPECIMENS, CADAVERS): Ninteen patients with chronic recurrent TMJ dislocation (Fifteen bilateral and fourteen unilateral). INTERVENTIONS: Autologous blood injected, 2ml in superior joint space (SJS) and 1 ml in peri-capsular tissue (PT) under ultra sound guidance. MAIN OUTCOME MEASURE(S): Reduction in number of dislocation episodes, maximal mouth opening, pain (visual analogue scale) and TMJ sounds (present or absent) at the end of 2 weeks, 3 months, 6 months and 1 year. RESULTS: At 2 weeks post operatively 18 patients (95%) were asymptomatic only one patient (5%) complained of Recurrence of dislocation and was treated successfully by a 2(nd) injection. At subsequent follow up visits none reported dislocation. CONCLUSION(S): US guided ABI for patients with chronic recurrent TMJ dislocations serves as an alternative, minimally invasive, highly effective and accurate modality of treatment since it includes exposure without radiation, real-time visualization of soft tissues, visualization of the needle tip advancement, local anesthetic spread relevant to the surrounding structures which can be performed on an outpatient basis.