Surgery Overview
Open-joint arthroplasty is surgery to repair, reposition, replace,
or remove parts in a joint. When used to treat
temporomandibular (TM) joint disorder, this usually
involves the articular disc that cushions the jaw joint.
During open-joint arthroplasty of the jaw, an incision is made in
the skin to expose the jaw joint. The surgeon may repair, reposition, or
replace the disc with your own tissue or an artificial disc. Scar tissue or
bony growths in the jaw joint can also be removed.
Open-joint arthroplasty is done under
general anesthesia. You can normally expect to go home
the same day.
When jaw joint movement cannot be regained because the disc has
changed too much or the joint has broken down, the surgeon may need to remove
the disc (discectomy) and replace it with an artificial disc.
What To Expect After Surgery
After surgery, medicines are prescribed to relieve pain and reduce
swelling.
You can start physical therapy within 48 hours to maintain movement
and prevent scar tissue from forming.
You may be given a mouthpiece (splint) to wear while rehabilitating
your jaw.
Why It Is Done
Open-joint arthroplasty is used when:
- There are bony growths within the jaw joint.
Such growths are hard to reach with
arthroscopic methods.
- Complications from a
previous surgery occur, such as the failure of an artificial joint
replacement.
- The joint is fused together by bony growth
(ankylosis).
- The joint is not accessible with arthroscopic
surgery.
How Well It Works
When open-joint surgery is the best option, it is usually helpful.
Disc repositioning surgery, sometimes combined with reshaping the disc and
bone, has good results 80% to 95% of the time.2
Other procedures, such as those using implants, have had less success, but are
the only option for some patients.1
Risks
Possible complications include:
- Loss of jaw movement. Everyone has some
decrease in jaw mobility after surgery because the jaw heals with scar tissue,
which is harder and tighter than normal tissue. But jaw exercises will help jaw
movement.
- Adverse reaction to the materials in an artificial disc.
The risk of tissue rejection is higher if artificial materials, rather than
your own tissue, are used.
What To Think About
When possible, a nonsurgical approach is preferred over surgery,
because it is cheaper, safer,
noninvasive, and involves less risk of permanent
damage.
Current practice trends are to avoid altering disc position or
structure. After disc replacement, an adverse reaction to an
artificial disc is possible.
Repeat surgery is less likely to produce positive results.
Surgeries done using open-joint arthroplasty require more
recovery time than do arthroscopic surgeries.
If your doctor recommends surgery, experts agree that it is best to
get a second opinion.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- National Institutes of Health (1996). Management of temporomandibular disorders. Technology Assessment Conference Statement, April 29–May 1, 1996. Available online: http://consensus.nih.gov/1996/1996TemporomandibularDisorders018PDF.pdf.
- Tucker MR, et al. (2008). Management of
temporomandibular disorders. In JR Hupp et al., eds., Contemporary Oral and Maxillofacial Surgery, 5th ed., pp.
629–649. St. Louis: Mosby Elsevier.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
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| Specialist Medical Reviewer | Steven K. Patterson, BS, DDS, MPH - Dentistry |
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| Last Revised | January 13, 2010 |
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National Institutes of Health (1996). Management of temporomandibular disorders. Technology Assessment Conference Statement, April 29–May 1, 1996. Available online: http://consensus.nih.gov/1996/1996TemporomandibularDisorders018PDF.pdf.
Tucker MR, et al. (2008). Management of
temporomandibular disorders. In JR Hupp et al., eds., Contemporary Oral and Maxillofacial Surgery, 5th ed., pp.
629–649. St. Louis: Mosby Elsevier.
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