Acromioclavicular Joint/pathology* ; Humans ; Joint Dislocations/pathology*

Finger Joint ; diagnostic imaging ; pathology ; Humans ; Joint Dislocations ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Radiography

Objective: To explore the correlation between the attachment type of lateral pterygoid muscle (LPM) and the position of temporomandibular joint (TMJ) disc in patients with temporomandibular disorders (TMD) by using wireless amplified magnetic resonance imaging detector (WAND) coupled with conventional head and neck joint coil for high resolution imaging of TMJ. Methods: Eighty-five patients with TMD diagnosed by oral and maxillofacial surgeons of Guizhou Provincial People's Hospital from October 2019 to January 2022 were collected. A total of 160 TMJ were included. There were 16 males and 69 females, aged (32.7±14.2) years. All patients were scanned with open, closed oblique sagittal and coronal WAND coupled head and neck coils with bilateral TMJ. Based on TMJ and LPM high resolution imaging, to explore the correlation between LPM attachment types and the position of TMJ disc in TMD patients, and to evaluate the potential clinical value of LPM attachment types in TMD patients. χ² test and Pearson correlation analysis were used to evaluate the correlation between LPM attachment type and TMJ disc location. Results: There were three types of LPM attachment: type Ⅰ in 51 cases [31.9% (51/160)], type Ⅱ in 77 cases [48.1% (77/160)] and type Ⅲ in 32 cases [20.0% (32/160)]. There was a significant correlation between the type of LPM attachment and the position of articular disc (χ²=28.20, P=0.002, r=0.776). There was no statistical significance between the type of LPM attachment and the reversible displacement of articular disc (χ²=0.24, P=0.887, r=0.825). Conclusions: There is a correlation between the attachment type of LPM and the position of the disc in TMD patients. WNAD coupled with conventional head and neck joint coil TMJ high resolution scan can provide reliable imaging evidence for TMD patients in evaluating the type of LPM attachment and the location of disc.
Male ; Female ; Humans ; Temporomandibular Joint Disc/pathology* ; Pterygoid Muscles/pathology* ; Joint Dislocations ; Temporomandibular Joint Disorders/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Temporomandibular Joint/pathology*

OBJECTIVETo study the chondrocyte apoptosis in rabbit temporomandibular joint after anterior disc displacement.

METHODSExperimental anterior disc displacement was induced surgically in 20 Japanese rabbits without opening their temporomandibular joint bursas. Histopathologic and apoptotic (TUNEL) analysis was used to evaluate the changes in articular cartilage, disc and synovium.

RESULTSCondyle chondrocyte showed apoptosis most obviously at 1 or 2 weeks after surgery, and apoptotic cells concentrated in proliferative zone and hypertrophic zone. 4 or 6 weeks after surgery, the joint went into a remodelling period.

CONCLUSIONSChondrocyte apoptosis in temporomandibular joint will be activated after anterior disc displacement, which initiates the remodelling in temporomandibular joint.

Animals ; Apoptosis ; Chondrocytes ; pathology ; In Situ Nick-End Labeling ; Joint Dislocations ; physiopathology ; Rabbits ; Temporomandibular Joint ; physiopathology ; Temporomandibular Joint Disc ; physiopathology

OBJECTIVETo study the adaptive alterations of elastic fibers in the bilaminar zone (BZ) of rabbit temporomandibular joint (TMJ) following disc displacement.

METHODSTwenty-eight Japanese white rabbits were used in this study. The right temporomandibular joints of 20 of 28 rabbits were subjected to the surgical procedure of anterior disc displacement (ADD). Four rabbits in the surgical group were sacrificed at 2, 4, 6, 8 and 12 weeks after operation. Their temporomandibular joints were studied histochemically.

RESULTSElastic fibers were reduced in number and ran irregularly in the superior lamina of BZ from ADD rabbits. The jungly elastic fibers (EFs) could still be seen at 2 weeks after operation. At 4 weeks, the number of EFs decreased significantly; EFs lost their jungly arrangement and were shaped like rough dots, of which the arrangement and the lengths were different. Six weeks after operation, many EFs were replaced by distorted, uneven, non-oriented fine EFs, distributed unevenly and some thick or fine EFs that ran irregularly. The number of EFs decreased further and their arrangement was more deranged at 8 weeks. At 10 and 12 weeks, EFs in the superior lamina of BZ were similar to those at 8 weeks.

CONCLUSIONOur results show that EFs lost their function as well as their distribution and arrangement after disc displacement.

Adaptation, Physiological ; Animals ; Behavior, Animal ; Elastic Tissue ; pathology ; Extracellular Matrix ; pathology ; Joint Dislocations ; pathology ; Rabbits ; Temporomandibular Joint Disc ; pathology ; Temporomandibular Joint Disorders ; pathology

OBJECTIVES: This study aimed to use modified articular disc anchorage in treating old irreducible temporomandibular joint (TMJ) disc displacement with perforation and rupture, as well as to explore its efficacy. METHODS: A total of 31 patients (34 sides) with 47 TMJ disc perforations who underwent surgical treatment in the Affiliated Stomatolo-gical Hospital of Nanchang University from January 2018 to December 2021 were selected. According to the location of disc perforation, it has five types: posterior disc perforation (typeⅠ), anterior disc perforation (typeⅡ), lateral disc perforation (type Ⅲ), composite disc perforation, and destruction disc perforation. The modified methods of disc anchoring were divided into two types according to the location of the perforation. TypesⅠandⅢ disc perforation were trea-ted by posterior anchoring method. For posterior ancho-ring, a screw was implanted into the posterolateral side of the condylar neck, and the disc was fixed on the screw by horizontal mattress suture. TypeⅡdisc perforation and compo-site disc perforation combined typeⅡperforation were treated by anterior and posterior double-anchoring method. For anterior anchoring, anchor screws or holes were placed at the anterior edge of the condylar neck, and horizontal mattress suture was performed at the posterior edge of the anterior perforation with an anchor wire. The articular disc was then fixed on the anchor screws or holes. For the posterior anchoring method, it was the same as the previous one. Paired t test was used to analyze the visual analog scale (VAS), maximum interincisal opening (MIO), and TMJ disorder index (CMI) of the patient before surgery and 1, 3, and 6 months after surgery. Disk-condyle position relationship by magnetic resonance imaging and postoperative quality of life in postoperative were analyzed. RESULTS: The incidence of perforation was 41.2% (14/34) in typeⅠ, 11.8% (4/34) in typeⅡ, 8.8% (3/34) in typeⅢ, 29.4% (10/34) in composite type, and 8.8% (3/34) in destruction type. The VAS, MIO, and CMI at 3, 6 months after operation significantly improved compared with those before operation (P<0.05). The effective reduction rate of disc was 96.77% (30/31). The quality of life at 6 months after surgery was 47.22±2.13, and the rate of excellent evaluation was 96.4% (27/28). CONCLUSIONS Modified articular disc anchorage achieves a good curative effect for treating temporomandibular joint disc perforation and rupture. Nevertheless, its long-term effect requires further observation.
Humans ; Temporomandibular Joint Disc/surgery* ; Quality of Life ; Joint Dislocations/surgery* ; Temporomandibular Joint Disorders/surgery* ; Magnetic Resonance Imaging/methods* ; Temporomandibular Joint/pathology* ; Mandibular Condyle

Traumatic anterior dislocation of the shoulder is one of the most common directions of instability following a traumatic event. Although the incidence of shoulder dislocation is similar between young and elderly patients, most studies have traditionally focused on young patients due to relatively high rates of recurrent dislocations in this population. However, shoulder dislocations in older patients also require careful evaluation and treatment selection because they can lead to persistent pain and disability due to rotator cuff tears and nerve injuries. This article provides an overview of the nature and pathology of acute primary anterior shoulder dislocation, widely accepted management modalities, and differences in treatment for young and elderly patients.
Aged ; Dislocations ; Humans ; Incidence ; Pathology ; Rotator Cuff ; Shoulder Dislocation ; Shoulder Joint ; Shoulder ; Tears

Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.
Accidents, Traffic ; Elbow Joint ; injuries ; Hip Dislocation ; complications ; pathology ; Humans ; Joint Dislocations ; complications ; Male ; Soft Tissue Injuries ; complications ; Young Adult

Atlanto-Axial Joint ; pathology ; physiopathology ; Child, Preschool ; Female ; Humans ; Joint Dislocations ; etiology ; Tomography, X-Ray Computed ; Wounds and Injuries ; complications

OBJECTIVETo study the adaptive alteration in bilaminar zone of rabbits' temporomandibular joint following disc displacement.

METHODSTwenty-six Japanese white rabbits were used in this study. Among these rabbits,6 were used as controls. The right discs of other 20 rabbits were displaced anteriorly by operation. Four of these rabbits were killedatn 1, 2, 4, 6 and 8 weeks respectively after surgery. The TMJS were studied by HE staining, Alcin bluen staining and in situ detection of type II collagen mRNA expression.

RESULTSThere appeared cartilage metaplasia after one week following disc displacement. Typical chondrocytes could be found in the bilaminar zone. The new chondrocytes expressed type II collagen.

CONCLUSIONSThe bilaminar zone of TMJ will be remodeled following disc displacement and become a disc-like tissue to function as a disc.

Animals ; Collagen Type II ; biosynthesis ; genetics ; Female ; Joint Dislocations ; metabolism ; Male ; RNA, Messenger ; biosynthesis ; Rabbits ; Temporomandibular Joint Disc ; metabolism ; pathology ; Temporomandibular Joint Disorders ; metabolism ; pathology