Enhanced recovery after surgery (ERAS) improves TMJ function and hospital efficiency in ADDwoR patients: a retrospective cohort study

Enhanced recovery after surgery (ERAS) improves outcomes in various surgical fields, but its role in disc anchorage for anterior disc displacement without reduction (ADDwoR) is unclear. This retrospective cohort study evaluated the impact of a standardized ERAS protocol on functional recovery and operational efficiency in these patients. The study reviewed patients who underwent disc anchorage surgery between January 2023 and December 2024. After exclusions, 790 patients were included and divided into an ERAS group ( n = 398 patients) and a conventional group ( n = 392 patients). The primary outcome was TMJ function, assessed using Helkimo anamnestic (Ai) and clinical dysfunction (Di) scores preoperatively and 1 year postoperatively. Secondary outcomes included maximum mouth opening (MMO), pain visual analog scale (VAS) scores, masticatory ability scores, postoperative complications incidence, and medical operational efficiency. Baseline characteristics were comparable between groups. At 1 year follow-up, the ERAS group demonstrated superior TMJ function, with significantly more patients achieving no dysfunction (Di 0: 83.4% vs 48.2%), fewer experiencing severe dysfunction (Di II/III: 1.3% vs 7.7%), greater MMO (4.1 ± 0.6 vs 3.1 ± 0.5 cm), lower pain scores (0.5 ± 0.3 vs 1.8 ± 0.7), and better masticatory ability. Overall complication rates were significantly reduced (overall: 5.5% vs 12.3%), particularly mouth opening pain (0.3% vs 22.7%) and temporary malocclusion (0.5% vs 8.2%). Operationally, the ERAS group had shorter hospital stays (5.1 ± 1.2 vs 7.3 ± 2.9 days), lower hospitalization costs (19 607 ± 4843 vs 25 377 ± 4587), and higher patient satisfaction. Implementation of a standardized ERAS protocol significantly enhances TMJ functional recovery, improves pain control, reduces complications, and optimizes operational efficiency in ADDwoR patients undergoing disc anchorage surgery.