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

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Incision: A small incision is made in front of the ear to access the TMJ.
3. Removal: The damaged joint structures are carefully removed.
4. Placement: The prosthetic joint is placed and secured in position.
5. Closure: The incision is closed with sutures.
6. 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.