Intra-articular injection of hyaluronic acid versus platelet-rich plasma following single puncture arthrocentesis for the management of internal derangement of TMJ: A double-blinded randomised controlled trial
The present study aimed to compare the efficacies of intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) following single needle arthrocentesis in patients with TMJ internal derangement. This double-blinded randomised controlled trial involved the enrolment of patients...
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| Veröffentlicht in: | Journal of cranio-maxillo-facial surgery 2022-11, Vol.50 (11), p.825-830 |
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| creator | Dasukil, Saubhik Arora, Geetanjali Boyina, Kiran Kumar Jena, Ashok Kumar Jose, Anson Das, Snigdho |
| description | The present study aimed to compare the efficacies of intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) following single needle arthrocentesis in patients with TMJ internal derangement.
This double-blinded randomised controlled trial involved the enrolment of patients diagnosed with unilateral TMD, falling into either Wilkes' stages II or III. In Group A, single needle arthrocentesis was performed using Ringer's lactate serving as a control group; in Group B, intra-articular injection of 1 ml hyaluronic acid injection was given following arthrocentesis; and in Group C, autologous intraarticular injections of 1 ml of PRP was given after arthrocentesis, twice in two weeks' interval. The primary outcome variables were maximum mouth opening and pain, while TMJ clicking sounds formed the secondary outcome variable. All the outcome variables were assessed preoperatively (T0) and postoperatively after the second dose of injection at one month (T1), three months (T2), and six months (T3). The alpha level was set to p |
| doi_str_mv | 10.1016/j.jcms.2022.10.002 |
| format | Article |
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This double-blinded randomised controlled trial involved the enrolment of patients diagnosed with unilateral TMD, falling into either Wilkes' stages II or III. In Group A, single needle arthrocentesis was performed using Ringer's lactate serving as a control group; in Group B, intra-articular injection of 1 ml hyaluronic acid injection was given following arthrocentesis; and in Group C, autologous intraarticular injections of 1 ml of PRP was given after arthrocentesis, twice in two weeks' interval. The primary outcome variables were maximum mouth opening and pain, while TMJ clicking sounds formed the secondary outcome variable. All the outcome variables were assessed preoperatively (T0) and postoperatively after the second dose of injection at one month (T1), three months (T2), and six months (T3). The alpha level was set to p < 0.05.
Ninety patients (N = 90) comprised the final sample size of the study with thirty patients(n = 30) in each treatment group. A statistically significant decrease in the management in mean pain scores was noted between T0 [mean scores were 7.30 ± 1.05 (Group A), 7.63 ± 1.12 (Group B), and 7.56 ± 1.04(Group C)] and T3 [mean scores were 2.66 ± 0.88 (Group A), 2.4 ± 0.72 (Group B), and 1.66 ± 0.66 (Group C)] time intervals between Group A and C(p < 0.001). Significant improvement was noted in preoperative maximum mouth opening (MMO) of Group A, B, and C which was 22.83 ± 3.58, 22.17 ± 4.07, and 21.37 ± 3.69, respectively to 28.90 ± 2.72, 32.17 ± 3.97, and 34.10 ± 3.80 mm, respectively at six months postoperatively (p < 0.001). A significant decrease in joint sounds was evident for all three groups(p = 0.003 for Group A, p < 0.001 for Group B, and p < 0.001 for Group C) across the time intervals. Moreover, Group C showed a significant decrease in the prevalence of joint sound compared to the other two groups at all-time intervals postoperatively when equated to baseline (p = 0.02 at T1, p = 0.009 at T2, and p = 0.002 at T3).
Within the limitations of the present study, it can be concluded that intra-articular PRP may be preferable over HA whenever appropriate, following single needle arthrocentesis in the treatment of TMJ internal derangement.</description><identifier>ISSN: 1010-5182</identifier><identifier>EISSN: 1878-4119</identifier><identifier>DOI: 10.1016/j.jcms.2022.10.002</identifier><identifier>PMID: 36372680</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Arthrocentesis ; Humans ; Hyaluronic acid ; Hyaluronic Acid - therapeutic use ; Injections, Intra-Articular ; Pain - drug therapy ; Platelet-Rich Plasma ; PRP ; Range of Motion, Articular ; Single-needle arthrocentesis ; Temporomandibular Joint Disorders - drug therapy ; Temporomandibular Joint Disorders - surgery ; Treatment Outcome</subject><ispartof>Journal of cranio-maxillo-facial surgery, 2022-11, Vol.50 (11), p.825-830</ispartof><rights>2022 European Association for Cranio-Maxillo-Facial Surgery</rights><rights>Copyright © 2022 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c286t-2b5ee8280299a136d53f231e48babe825a2c2afc6ee0c820834f15346ea472893</citedby><cites>FETCH-LOGICAL-c286t-2b5ee8280299a136d53f231e48babe825a2c2afc6ee0c820834f15346ea472893</cites><orcidid>0000-0002-9061-748X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcms.2022.10.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36372680$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dasukil, Saubhik</creatorcontrib><creatorcontrib>Arora, Geetanjali</creatorcontrib><creatorcontrib>Boyina, Kiran Kumar</creatorcontrib><creatorcontrib>Jena, Ashok Kumar</creatorcontrib><creatorcontrib>Jose, Anson</creatorcontrib><creatorcontrib>Das, Snigdho</creatorcontrib><title>Intra-articular injection of hyaluronic acid versus platelet-rich plasma following single puncture arthrocentesis for the management of internal derangement of TMJ: A double-blinded randomised controlled trial</title><title>Journal of cranio-maxillo-facial surgery</title><addtitle>J Craniomaxillofac Surg</addtitle><description>The present study aimed to compare the efficacies of intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) following single needle arthrocentesis in patients with TMJ internal derangement.
This double-blinded randomised controlled trial involved the enrolment of patients diagnosed with unilateral TMD, falling into either Wilkes' stages II or III. In Group A, single needle arthrocentesis was performed using Ringer's lactate serving as a control group; in Group B, intra-articular injection of 1 ml hyaluronic acid injection was given following arthrocentesis; and in Group C, autologous intraarticular injections of 1 ml of PRP was given after arthrocentesis, twice in two weeks' interval. The primary outcome variables were maximum mouth opening and pain, while TMJ clicking sounds formed the secondary outcome variable. All the outcome variables were assessed preoperatively (T0) and postoperatively after the second dose of injection at one month (T1), three months (T2), and six months (T3). The alpha level was set to p < 0.05.
Ninety patients (N = 90) comprised the final sample size of the study with thirty patients(n = 30) in each treatment group. A statistically significant decrease in the management in mean pain scores was noted between T0 [mean scores were 7.30 ± 1.05 (Group A), 7.63 ± 1.12 (Group B), and 7.56 ± 1.04(Group C)] and T3 [mean scores were 2.66 ± 0.88 (Group A), 2.4 ± 0.72 (Group B), and 1.66 ± 0.66 (Group C)] time intervals between Group A and C(p < 0.001). Significant improvement was noted in preoperative maximum mouth opening (MMO) of Group A, B, and C which was 22.83 ± 3.58, 22.17 ± 4.07, and 21.37 ± 3.69, respectively to 28.90 ± 2.72, 32.17 ± 3.97, and 34.10 ± 3.80 mm, respectively at six months postoperatively (p < 0.001). A significant decrease in joint sounds was evident for all three groups(p = 0.003 for Group A, p < 0.001 for Group B, and p < 0.001 for Group C) across the time intervals. Moreover, Group C showed a significant decrease in the prevalence of joint sound compared to the other two groups at all-time intervals postoperatively when equated to baseline (p = 0.02 at T1, p = 0.009 at T2, and p = 0.002 at T3).
Within the limitations of the present study, it can be concluded that intra-articular PRP may be preferable over HA whenever appropriate, following single needle arthrocentesis in the treatment of TMJ internal derangement.</description><subject>Arthrocentesis</subject><subject>Humans</subject><subject>Hyaluronic acid</subject><subject>Hyaluronic Acid - therapeutic use</subject><subject>Injections, Intra-Articular</subject><subject>Pain - drug therapy</subject><subject>Platelet-Rich Plasma</subject><subject>PRP</subject><subject>Range of Motion, Articular</subject><subject>Single-needle arthrocentesis</subject><subject>Temporomandibular Joint Disorders - drug therapy</subject><subject>Temporomandibular Joint Disorders - surgery</subject><subject>Treatment Outcome</subject><issn>1010-5182</issn><issn>1878-4119</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UctuFDEQHCEQecAPcEA-cpnF9jzWi7hEEYSgIC7hbPXYPVmPPPZiexLlM_kjerQBblzs7urqarerqt4IvhFc9O-nzWTmvJFcSgI2nMtn1alQW1W3QuyeU8wFrzuh5El1lvPEOe-52r2sTpq-2cpe8dPq13UoCWpIxZnFQ2IuTGiKi4HFke0fwS8pBmcYGGfZPaa8ZHbwUNBjqZMz-zXLM7Axeh8fXLhjmQ6P7LAEU5aEjMT3KRoMBbPLREys7JHNEOAOZ4LXUY6qKYBnFhOEf_jtt68f2AWzcRk81oN3waJlRLFxdplCE2kDmk1hSQ78q-rFCD7j66f7vPrx-dPt5Zf65vvV9eXFTW2k6ksthw5RScXlbgei6W3XjLIR2KoBBip0II2E0fSI3CjJVdOOomvaHqHdSrVrzqt3R91Dij8XzEXTewx6DwHjkrXc0i_zlvqIKo9Uk2LOCUd9SG6G9KgF16uVetKrlXq1csXISmp6-6S_DDPavy1_vCPCxyMBact7h0ln4zAYtC6RhdpG9z_93ww_ta4</recordid><startdate>202211</startdate><enddate>202211</enddate><creator>Dasukil, Saubhik</creator><creator>Arora, Geetanjali</creator><creator>Boyina, Kiran Kumar</creator><creator>Jena, Ashok Kumar</creator><creator>Jose, Anson</creator><creator>Das, Snigdho</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9061-748X</orcidid></search><sort><creationdate>202211</creationdate><title>Intra-articular injection of hyaluronic acid versus platelet-rich plasma following single puncture arthrocentesis for the management of internal derangement of TMJ: A double-blinded randomised controlled trial</title><author>Dasukil, Saubhik ; Arora, Geetanjali ; Boyina, Kiran Kumar ; Jena, Ashok Kumar ; Jose, Anson ; Das, Snigdho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c286t-2b5ee8280299a136d53f231e48babe825a2c2afc6ee0c820834f15346ea472893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Arthrocentesis</topic><topic>Humans</topic><topic>Hyaluronic acid</topic><topic>Hyaluronic Acid - therapeutic use</topic><topic>Injections, Intra-Articular</topic><topic>Pain - drug therapy</topic><topic>Platelet-Rich Plasma</topic><topic>PRP</topic><topic>Range of Motion, Articular</topic><topic>Single-needle arthrocentesis</topic><topic>Temporomandibular Joint Disorders - drug therapy</topic><topic>Temporomandibular Joint Disorders - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dasukil, Saubhik</creatorcontrib><creatorcontrib>Arora, Geetanjali</creatorcontrib><creatorcontrib>Boyina, Kiran Kumar</creatorcontrib><creatorcontrib>Jena, Ashok Kumar</creatorcontrib><creatorcontrib>Jose, Anson</creatorcontrib><creatorcontrib>Das, Snigdho</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cranio-maxillo-facial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dasukil, Saubhik</au><au>Arora, Geetanjali</au><au>Boyina, Kiran Kumar</au><au>Jena, Ashok Kumar</au><au>Jose, Anson</au><au>Das, Snigdho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intra-articular injection of hyaluronic acid versus platelet-rich plasma following single puncture arthrocentesis for the management of internal derangement of TMJ: A double-blinded randomised controlled trial</atitle><jtitle>Journal of cranio-maxillo-facial surgery</jtitle><addtitle>J Craniomaxillofac Surg</addtitle><date>2022-11</date><risdate>2022</risdate><volume>50</volume><issue>11</issue><spage>825</spage><epage>830</epage><pages>825-830</pages><issn>1010-5182</issn><eissn>1878-4119</eissn><abstract>The present study aimed to compare the efficacies of intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) following single needle arthrocentesis in patients with TMJ internal derangement.
This double-blinded randomised controlled trial involved the enrolment of patients diagnosed with unilateral TMD, falling into either Wilkes' stages II or III. In Group A, single needle arthrocentesis was performed using Ringer's lactate serving as a control group; in Group B, intra-articular injection of 1 ml hyaluronic acid injection was given following arthrocentesis; and in Group C, autologous intraarticular injections of 1 ml of PRP was given after arthrocentesis, twice in two weeks' interval. The primary outcome variables were maximum mouth opening and pain, while TMJ clicking sounds formed the secondary outcome variable. All the outcome variables were assessed preoperatively (T0) and postoperatively after the second dose of injection at one month (T1), three months (T2), and six months (T3). The alpha level was set to p < 0.05.
Ninety patients (N = 90) comprised the final sample size of the study with thirty patients(n = 30) in each treatment group. A statistically significant decrease in the management in mean pain scores was noted between T0 [mean scores were 7.30 ± 1.05 (Group A), 7.63 ± 1.12 (Group B), and 7.56 ± 1.04(Group C)] and T3 [mean scores were 2.66 ± 0.88 (Group A), 2.4 ± 0.72 (Group B), and 1.66 ± 0.66 (Group C)] time intervals between Group A and C(p < 0.001). Significant improvement was noted in preoperative maximum mouth opening (MMO) of Group A, B, and C which was 22.83 ± 3.58, 22.17 ± 4.07, and 21.37 ± 3.69, respectively to 28.90 ± 2.72, 32.17 ± 3.97, and 34.10 ± 3.80 mm, respectively at six months postoperatively (p < 0.001). A significant decrease in joint sounds was evident for all three groups(p = 0.003 for Group A, p < 0.001 for Group B, and p < 0.001 for Group C) across the time intervals. Moreover, Group C showed a significant decrease in the prevalence of joint sound compared to the other two groups at all-time intervals postoperatively when equated to baseline (p = 0.02 at T1, p = 0.009 at T2, and p = 0.002 at T3).
Within the limitations of the present study, it can be concluded that intra-articular PRP may be preferable over HA whenever appropriate, following single needle arthrocentesis in the treatment of TMJ internal derangement.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>36372680</pmid><doi>10.1016/j.jcms.2022.10.002</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-9061-748X</orcidid></addata></record> |
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| subjects | Arthrocentesis Humans Hyaluronic acid Hyaluronic Acid - therapeutic use Injections, Intra-Articular Pain - drug therapy Platelet-Rich Plasma PRP Range of Motion, Articular Single-needle arthrocentesis Temporomandibular Joint Disorders - drug therapy Temporomandibular Joint Disorders - surgery Treatment Outcome |
| title | Intra-articular injection of hyaluronic acid versus platelet-rich plasma following single puncture arthrocentesis for the management of internal derangement of TMJ: A double-blinded randomised controlled trial |
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