Arthrotomy, also known as Arthroplasty, is an open joint procedure done under general anesthesia in the hospital. The recovery is significantly longer, three to eight8 weeks, and more painful than the TMJ Arthrocentesis or TMJ Arthroscopy.
An incision is made similar to a face lift incision (along the ear), and the joint space is exposed for the surgeon to see. This allows for the removal of adhesions, osteophytes (bone spurs), fibrous or bony ankylosis (fusion), tumors, etc. This reshaping of the joint is called Arthroplasty.
The surgeon can also repair discs by suturing them into place (Discoplasty), remove discs (Discectomy), or implant anything from a temporalis muscle graft, to a rib. Some of the types of various procedures that are done through an open joint operation.
- Discoplasty. This inovolves surgically putting the disc back into its normal position when it is displaced.
- Discectomy. This provides disc removal. Some surgeons use a temporalis muscle or dermal graft to replace the disc. Others do not put anything in its place.
- Arthroplasty. Reshaping of the condyle and fossa when there are arthritic changes.
- Temporalis Muscle Graft. A piece of your temple muscle (temporalis) is slid into the joint space to prevent bone on bone contact.
- Temporary Silicone Implants. Silicone sheeting has been used in the past to act as a pseudo-disc. Silicone sheeting specifically marketed for the TMJ was voluntarily withdrawn from the market in 1993. After the TMJ implant fiasco of the early ninties, the FDA asked for pre-market approval on ALL devices to be implanted in the TMJ. No company submitted the required safety testing or pre-market approval paperwork for silicone. If a doctor mentions using silicone, he is doing it off-label. Beware! The FDA says on its Consumer Information page, “FDA is presently working with manufacturers to appropriately label silicone sheeting with warnings against its use in the TMJ implant.”
- Rib Grafts. These are used to replace the condyle.
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