Abstract Background Internal derangements of the temporomandibular joint are common in young female patients and frequently associated with hypermobility. Increased joint laxity, often quantified by the Beighton score, may predispose to recurrent or intermittent locking and complicate management. Arthroscopic surgery has been proposed as a minimally invasive yet effective treatment modality in this setting. Objective This study evaluates the outcomes of level II and III arthroscopic interventions in 120 young hypermobile female patients aged 16–30 years, diagnosed with Wilkes stage II–IV, and explores the relationship between Beighton scores and clinical outcomes. Methods All patients underwent comprehensive clinical and radiological evaluation, including OPG, MRI, and CT when indicated. Hypermobility was assessed using the Beighton scoring system, and patients were classified as hypermobile according to validated thresholds. Arthroscopic procedures included lysis and lavage, adhesiolysis, disc plication, and synovial release, as needed. Outcomes were measured by pain reduction (VAS scale), maximum mouth opening, diet scores, and an overall assessment of quality of life. Results Arthroscopic management resulted in significant pain reduction, functional improvement, and decreased locking episodes across the cohort, with no major complications. Importantly, even patients with marked hypermobility achieved favourable outcomes without progression to degenerative disease during follow-up. Conclusions Level II–III arthroscopy is an effective treatment for hypermobile female patients with TMJ internal derangements. Correlation with Beighton scores highlights the role of joint laxity in disease expression, while early arthroscopic intervention can preserve function, reduce morbidity, and improve long-term quality of life.
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