Walker repair of the temporomandibular joint: A retrospective evaluation of 117 patients

Purpose: This study evaluated the outcome of a high condylar shave with meniscal repositioning (Walker repair) in patients with internal derangement of the temporomandibular joint (TMJ). Changes in incisal opening, pain level, chewing ability, and preoperative TMJ symptoms (tinnitus, vertigo, and crepitus) were evaluated. Patients and Methods: A retrospective evaluation of 202 patients undergoing the Walker repair was completed using a questionnaire. A total of 117 patients responded to the questionnaire. Preoperative and postoperative examination findings, subjective questionnaire results, and panorex radiographs were analyzed. Results: The Walker repair resulted in a statistically significant (P < .001) decrease in pain by an average of 5.6 points on a scale of 0 to 10. The procedure also improved incisal opening by an average of 5.8 mm (P < .001). Improvements of 69% in tinnitus, 72% in vertigo, and 66% in crepitus were documented. Patients evaluated their motion, diet, comfort, and overall improvement; each area was rated as good or excellent by more than 90% of patients. The overall success rate for the Walker repair was 86%. Conclusions: The Walker repair is an effective surgical treatment for internal derangement that significantly decreases pain level and increases incisal opening. No statistically significant difference in the success rate between unilateral and bilateral procedures was noted. (c) 2007 American Association of Oral and Maxillofacial Surgeons.