The choice of the surgical technique depends on the position, shape and extent of damage of the disc. To start with, minimally invasive procedures such us arthrocentesis, arthroscopy, arthroscopic lysis and lavage are used. Arthrocentesis, arthroscopic lysis and lavage result in removal of adhesions and fibrillations, lead to disc release and induce its taking the physiological position.
In the case of loss of the elasticity of the retrodiscal tissue and severe extension, the return of the disc is impossible and its reposition is done. Repositioning of the disc is effective when it comes to anterior disc displacement without severe disc deformation or perforation. Long-term results of the disc’s plication to soft tissues are questionable since inflamed ligaments are not able to fix the disc. In the case of discopexy, disc’s fixation to hard tissues has demonstrated more stable and better long-term results.
Disc removal is indicated if the disc is perforated, fragmented or strongly fixed. Discectomy with disc replacement is more effective in preventing degenerative changes. As alloplastic materials cause severe foreign body reaction, autogenous grafts are mostly used nowadays. Since conservative treatment in the case of various TMJ pathologies is not always effective, surgical approaches can improve patients’ life quality.