TMJ Arthroscopy
A TMJ arthroscopy is a procedure that is a little more involved and invasive than the previous procedure covered, the arthrocentesis. This procedure is almost always done in the outpatient facilities in the hospital. A scope is used to take a look inside your joint to see what is causing problems. Some surgeons will not only look inside, but perform procedures while they are in there like suturing the discs into place. Please do research on this procedure. I have not met a patient yet with successful results from a disc suturing procedure (whether it be an arthroscopy or arthroplasty), however, it does not mean that they do not exist. The surgeon will also remove any loose scar tissue.
You will be checked in prior to your surgery time and an IV will be started. The anesthesiologist will visit and take a look at your opening, and everyone will check and double check your information and allergies.
Usually, before the surgery, the surgeon will come and visit you to discuss what he will be doing and what it will be like when you wake up. You have usually already had a pre-op appointment to discuss all of this information, so it is just to make sure you have no questions. Please ask if you do have any questions!! No question is a stupid question!!
After this, the anesthesiologist and nurses will probably give you some medicine to help you relax, and then you are off to the operating room. You might be awake for this, and you might not. If you are, you will notice that the room is very cold and that there are a lot of people buzzing around getting ready for your surgery. Take a deep breath and close your eyes- try not to let it bother you. After all, they are all there to make sure YOU are okay. If at any point you aren’t, speak up! 
When you wake up, you will be in the recovery room. You might feel pain in your joints from the surgery. You also might have a pressure bandage on, which I call a “jaw bra.” Please let the nurses know if you are in pain, because they are there to give you medication and make sure you are comfortable.
Recovery time for this surgery is a couple days to a week. You will probably want to take off work for 3 days or so but make sure it is flexible in case you need extra time. Your surgeon will probably tell you to maintain your soft diet for a couple weeks. After a couple days you will probably start physical therapy as well.
When you visit the surgeon for your first post-operative appointment, he might be able to show you pictures from inside your joint.
As with all surgeries, there are advantages and disadvantages to this procedure. It does allow the surgeon to see the joint space(s) and possibly lysis and lavage any adhesions. The recovery is shorter and easier than an open joint procedure, and the scar is smaller (virtually undetectable). However, this surgery is much more expensive than an arthrocentesis, takes longer, and requires general anesthesia. Also, many studies have reported that arthrocentesis might be more successful than arthroscopy. Because of this and the fact that the arthrocentesis is so much easier , many surgeons might start to discontinue using the arthroscopy as a surgical treatment for TMJ disorder.
As with all invasive procedures, we recommend exhausting all conservative options before having multiple surgical opinions.
