Arthroscopic surgery of the temporomandibular joint includes the potential for iatrogenic damage of intracapsular structures during introduction of instruments and manipulation of the tissues. A modification of an elastoviscous solution of crosslinked sodium hyaluronate, called hylan fluid, was used for irrigation during surgery in 55 temporomandibular joints. Forty-nine of the joints were monitored postoperatively in a study to measure safety and efficacy of the material during the arthroscopic procedure. The hylan fluid was found to be as safe as the standard irrigating fluid. The hylan fluid also significantly protected the joint surfaces and facilitated the surgical procedure.