Arthrocentesis is often the first surgical procedure that will be done for a patient who has a displaced disc. It can be done as an in-office procedure, when it involves merely the placement of two hyperdermic needles into the joint, or as an outpatient procedure in the hospital if it is done arthroscopically. In the office, it can be done either under local anesthesia and IV sedation or general anesthesia. In the hospital, it is generally done under general anesthesia as an outpatient. When done with hyperdermic needles, the surgeon cannot visualize the joint. However, the literature shows that the results are similar to those obtained when the procedure is done arthroscopically.
Once the joint is numbed or you are put to sleep, the needles or the arthroscope are placed into the joint, and it is flushed with a sterile saline solution or a lactated Ringers solution. The purpose of this procedure is to remove tissue breakdown products and reduce inflammation. The surgeon will generally also manipulate the jaw to remove scar tissue adhesions that may have formed. Removal of adhesions is also done arthroscopically. At the end of the procedure, some surgeons inject a steroid into the joint.
Some surgeons claim that the disc can be repositioned arthroscopically. However, this is generally not possible. As long as there is good jaw mobility, most patients can function without the disc in normal position because the retrodiscal tissue adapts and acts as a pseudodisc.
When you get home (a few hours after the procedure), your joint and the surrounding area will be numb. If your doctor has given you a prescription for pain medication, this would be the best time to take it, as the pain will begin when the numbing medication wears off. You might have some swelling for a few days; however, most people are back at work after two to three days. There are generally no limits on physical activity or use of the jaw; usually the surgeon will recommend a jaw exercise program. You may be told to maintain a soft diet for a little while, but chances are you are already on one.
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