See it explained
In two minutes, Mr Komath explains what goes wrong in the jaw joint and how keyhole surgery can help.
Full video coming soon.
Treating the jaw joint through tiny incisions — including Level 2 and Level 3 operative arthroscopy, the most advanced keyhole techniques, with a faster recovery than open surgery.
Arthroscopy lets us see inside the jaw joint and treat it through openings just two to three millimetres wide.
Using a fine telescope and delicate instruments passed through tiny punctures in the skin crease in front of the ear, Mr Komath can inspect the joint, wash away the inflammatory debris that drives pain, release tight scar tissue, and — at the most advanced level — reposition and stabilise the displaced disc. Because nothing is opened widely, most people go home the same day and recover quickly.
Matched to the problem
Wash-out of the joint and release of early adhesions to relieve pain and improve opening.
Targeted work inside the joint — releasing adhesions, treating inflamed lining and managing internal derangement.
The most technically demanding: repositioning and securing the disc (plication). Few surgeons in Europe perform it — and Mr Komath trains others in it.
Whether arthroscopy is right for you is decided after a thorough assessment and imaging — it is one option on a ladder of care, not a universal answer.
Mr Komath teaches the most advanced keyhole jaw surgery to other surgeons, leading Level 3 fellowships across Europe — Udine, Groningen, Amsterdam and London (Royal Free) — for the past seven years.
Where appropriate, arthroscopy is paired with a regenerative PRP injection. Mr Komath has published on this approach (Keidar Zar Rab & Komath, EJSOFS, 2024).
When regenerative treatment is used, the cells are your own (autologous) — harvested during the same operation under one anaesthetic and concentrated directly into the joint to make the most of their regenerative potential. Because they are not genetically modified, the risks associated with genetically engineered cell therapies do not apply.
For some patients, botulinum toxin into the chewing muscles shortly before arthroscopy can ease post-operative muscle spasm — an approach supported by a randomised trial (Ângelo et al., 2023). Read more about pre-op Botox →
Because of this advanced skill set, we aim to preserve your natural joint arthroscopically wherever possible — and in suitable patients this can achieve good results even in advanced, Wilkes stage 5 (end-stage) disease. In line with national (NICE) guidance, total joint replacement is reserved for joints that remain unsalvageable and refractory to treatment.
In two minutes, Mr Komath explains what goes wrong in the jaw joint and how keyhole surgery can help.
Most people return to light activities within one to two weeks, guided by gentle jaw exercises. As with any procedure there are risks, and we consent you fully beforehand — these include pain, swelling, bruising, infection, a scar, numbness or altered sensation, temporary weakness of some facial muscles, temporary dullness of hearing, and a temporary bite change. Some patients have persistent symptoms, and around 8% may need a further operation. The keyhole incisions are closed with dissolving stitches; keeping them clean in the first week avoids an occasional stitch abscess, and if regenerative cells are harvested the donor site (lower abdomen or bone-marrow site) can bruise. Exceedingly rarely — fewer than 1 in 100,000 cases (under 0.001%) — serious complications affecting vision or hearing have been reported; we mention these because of their seriousness, despite how unlikely they are.
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