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Postoperative physiotherapy29912IntroductionWell-defined indications for temporomandibular surgery exist. Arthroscopy and arthrocentesis can be considered in patients with osteoarthritis and patients with a displaced disk leading to pain or impaired mouth opening. When these indications are properly met, an efficacy of up to 83.5% can be achieved.(1,2) Open surgery, such as a discectomy, can be considered in cases of severe disk perforation or perseverance of disk displacement symptoms without reduction despite previous discopexy. It can even be considered for partial or total joint replacement (TJR) using an autogenous transplant. Alloplastic replacement can also be considered, although this should be seen as the last resort out of a poor condition.(3,4) Although temporomandibular joint (TMJ) surgery aims to improve joint movement and reduce joint pain, surgery induced disuse muscle atrophy of the masticatory muscles can occur. Furthermore, immobilization can lead to capsular changes and adhesion formation, as abnormal scar tissue formation can occur.(5,6) The use of physiotherapy after surgical treatment aims to relieve pain and inflammation and decrease swelling. It also aims to prevent joint contracture and adhesion formation from occurring.(7,8) Physiotherapy can be active or passive in nature. Passive therapy can entail heat or cold application to relax the muscles or decrease inflammation, respectively. Exercises including passive opening of the mouth with the aid of an apparatus, such as the TheraBite system (Atos Medical, Malmö, Sweden), also can be used. Continuous passive motion (CPM) has been used in the field of orthopedic surgery for quite some time, mainly in the immediate postoperative phase as a means to lessen the detrimental effects of immobilization and to increase range of motion (ROM).(9) In contrast, active exercises, rely on muscle and joint activation, such as electrostimulation of the muscle and opening and closing of the joint by the patient without any assistance.Despite the important role postoperative physiotherapy plays in other orthopedic articular surgeries, such as total knee or hip replacements, and although physiotherapy as a nonsurgical treatment for temporomandibular Nikolas de Meurechy NW.indd 299 05-06-2024 10:15