Long-term effectiveness of arthrocentesis with and without hyaluronic acid injection for treatment of temporomandibular joint osteoarthritis

J Oral Sci. 2019 Mar 28;61(1):82-88. doi: 10.2334/josnusd.17-0423. Epub 2019 Feb 28.


This study evaluated the long-term effectiveness of intra-articular temporomandibular joint arthrocentesis for patients with osteoarthritis and compared arthrocentesis/lavage alone with arthrocentesis/lavage and injected hyaluronic acid. Forty patients met the inclusion criteria, and 37 completed long-term follow-up (approximately 4 years). The patients were randomly allocated to two groups: arthrocentesis with lavage alone (A-group, n = 17) or combined with hyaluronic acid treatment (AS-group, n = 20). Standard two-needle arthrocentesis was performed. Pain and joint sounds were measured at baseline and approximately 4 years after treatment. Reported pain, as indicated by visual analogue scale (VAS) score, significantly decreased from baseline to the final follow-up examination in both groups. Mean VAS score decreased from 64 to 16 (P < 0.001) in the A-group and from 63 to 25 (P < 0.001) in the AS-group. Average maximum incisor opening increased significantly in both groups but did not significantly differ between groups (P = 0.223). Joint sounds did not significantly improve within groups (A-group, P = 0.495; AS-group, P = 0.236). Both methods resulted in significant long-term improvements in pain and jaw function.

Keywords: arthrocentesis; hyaluronic acid; intra-articular injections; temporomandibular joint disorder.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Arthrocentesis / standards*
  • Female
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Hyaluronic Acid / therapeutic use
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Osteoarthritis / drug therapy*
  • Osteoarthritis / surgery*
  • Temporomandibular Joint / pathology*


  • Hyaluronic Acid