Arthroplasty, temporomandibular joint, with prosthetic joint replacement
CPT4 code
Arthroplasty, Temporomandibular Joint, with Prosthetic Joint Replacement
Name of the Procedure:
Temporomandibular Joint (TMJ) Arthroplasty with Prosthetic Joint Replacement
Summary
TMJ arthroplasty with prosthetic joint replacement is a surgical procedure to replace a damaged temporomandibular joint (the joint connecting the jawbone to the skull) with a prosthetic device. This surgery aims to relieve pain and restore normal jaw function.
Purpose
The procedure addresses severe TMJ disorders, including arthritis, ankylosis (joint stiffness), and severe trauma. The goals are to alleviate pain, improve jaw movement, and enhance the patient's ability to eat and speak.
Indications
- Chronic jaw pain unresponsive to conservative treatments
- Severe TMJ arthritis or degeneration
- Joint ankylosis or immobility
- Significant trauma or injury to the TMJ
- Failed previous TMJ surgeries
Preparation
- Fasting for a specified period before surgery
- Discontinuation or adjustment of certain medications
- Pre-operative imaging studies such as X-rays, CT scans, or MRI
- Blood tests and medical evaluations to assess overall health
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
- Incision: A small incision is made in front of the ear to access the TMJ.
- Removal: The damaged joint structures are carefully removed.
- Placement: The prosthetic joint is placed and secured in position.
- Closure: The incision is closed with sutures.
- Recovery: The patient is moved to a recovery area to wake from anesthesia and receive post-operative care.
Duration
The procedure typically takes about 2 to 4 hours.
Setting
The procedure is performed in a hospital or specialized surgical center.
Personnel
- Oral and maxillofacial surgeon
- Anesthesiologist
- Surgical nurses and assistants
Risks and Complications
- Infection
- Bleeding
- Nerve injury resulting in numbness or weakness
- Prosthetic device failure or dislocation
- Jaw stiffness or limited range of motion
Benefits
Patients can expect significant pain relief and improved jaw function. These benefits are usually realized within a few weeks to a few months after surgery.
Recovery
- Hospital stay for 1-3 days following the procedure
- Prescription pain medication to manage discomfort
- Soft diet and limited jaw movement for several weeks
- Physical therapy to improve jaw mobility
- Follow-up appointments to monitor healing and prosthetic function
Alternatives
- Non-surgical treatments: medication, physical therapy, dental splints
- Less invasive surgical options: arthroscopy, TMJ repair surgery
- Pros of alternatives: Lower risk, shorter recovery
- Cons of alternatives: May not be effective for severe TMJ disorders
Patient Experience
Patients can expect to be under general anesthesia during the surgery, feeling no pain during the procedure. Post-operatively, they may experience swelling, discomfort, and restricted jaw movement. Pain management strategies, including prescribed medications and cold compresses, help manage these symptoms. Full recovery and the ability to enjoy the benefits of the surgery usually occur within a few months.