van533
08-10-2006, 06:01 PM
I've had TMJ for over 5 yrs now - nothing I've tried has worked very well (muscle relaxers, splint, anti-inflammatory, ice, & heat. TMJ got worse after Katrina (I live in Biloxi, MS) - go figure. So finally gave up and drove to New Orleans which has the only TMJ Specialist in this area now. Liked him & his staff & understood him & found him easy to talk to. He took x-rays, did an exam, and asked lots of questions. Recommends arthoscopy on both jaws following the MRI he's asked me to have.
I've done lots of research and am so-o-o undecided about surgery. Would be great if I could talk to someone who's had a good experience. About all I can find is folks who've had a bad experience. Anybody care to respond? I need some help here.
I've done lots of research and am so-o-o undecided about surgery. Would be great if I could talk to someone who's had a good experience. About all I can find is folks who've had a bad experience. Anybody care to respond? I need some help here.
Sponsor
Thelma-Louise
08-11-2006, 01:48 AM
I wish I could help but I haven't gotten there yet - I'm still fussing with splints, therapies and pain meds after 2 1/2 years so I am kind of curious as well. But here's a thought - a good dr usually doesn't mind giving you the names of other patients he has treated - do you think he would do this and maybe you can speak to someone else he treated with this?? Tell him it would help if you could speak with a another patient so you know what to expect. Keep in mind that results can be different for each person even if the same dr does the procedure b/c every one is different. I know there are privacy issues to contend with as well, but thought it might be worth a shot.
dani626
08-11-2006, 09:51 PM
Hello,
I too have been suffering from TMJ problems for some time now. Everything I tried so far has not "cured" me; I am a little better but still do not have full function of jaw. Anyhow, I know someone who has had arthroscopy last October and had a VERY SUCCESSFUL :) experience. She is now "cured" and has full function of jaw. She saw a doctor up in Syracuse, NY (which I am going to see next Friday which is 5 1/2 hours from my house). The doctor I see now is good and supposedly one of the top guys but he doesn't take my insurance or do the arthroscopic surgery). The guy in Syracuse takes the insurance and does the surgery. Since my therapies have not helped the Doc. that I am seeing now said I could "live" with the problem and do nothing or I might be a candidate for the surgery (which he does not recommend for some reason but said it is an option). Since I can only open between 25-33 mm (depending on the day) I am definitely thinking about the surgery since I know someone it worked for. I hope that helps and good luck with your decision!
I too have been suffering from TMJ problems for some time now. Everything I tried so far has not "cured" me; I am a little better but still do not have full function of jaw. Anyhow, I know someone who has had arthroscopy last October and had a VERY SUCCESSFUL :) experience. She is now "cured" and has full function of jaw. She saw a doctor up in Syracuse, NY (which I am going to see next Friday which is 5 1/2 hours from my house). The doctor I see now is good and supposedly one of the top guys but he doesn't take my insurance or do the arthroscopic surgery). The guy in Syracuse takes the insurance and does the surgery. Since my therapies have not helped the Doc. that I am seeing now said I could "live" with the problem and do nothing or I might be a candidate for the surgery (which he does not recommend for some reason but said it is an option). Since I can only open between 25-33 mm (depending on the day) I am definitely thinking about the surgery since I know someone it worked for. I hope that helps and good luck with your decision!
TiffanyAnn
08-11-2006, 10:32 PM
Hi:
I'm sorry I can't be more positive but I don't know of one single person who has had an arthroscopy that it has helped. I have known people to have several of them and NONE of them helped. I truthfully don't think this procedure will help anyone and I'd hate to see you waste your time, money and energy on it. It would be my suggestion that you avoid all TMJ surgery as in most cases it causes more problems than it fixes and leads to multiple other TMJ surgeries.
Tiffany
I'm sorry I can't be more positive but I don't know of one single person who has had an arthroscopy that it has helped. I have known people to have several of them and NONE of them helped. I truthfully don't think this procedure will help anyone and I'd hate to see you waste your time, money and energy on it. It would be my suggestion that you avoid all TMJ surgery as in most cases it causes more problems than it fixes and leads to multiple other TMJ surgeries.
Tiffany
rubato
08-12-2006, 09:32 AM
I'll give you my experience, but everyone's different. I had arthroscopy done on both sides in 1994. Very easy recovery. I had 10 full years of no pain at all. So, I thought I was "cured". I started having pain again in 2004. I ended up having a discectomy in 2005 because my disc was destroyed. I had a rough time with this recovery. But, after I recovered, I had been pain free for a year. I have started hurting again this week. I know the reason. I've been enjoying being free of pain and have been eating raw carrots, and apples without slicing them and bagels and whatever bad for you things I can think of. My doctor doesn't believe in doing joint replacements and after hearing things on this board, I wouldn't do it anyway. From here on out, I will try to manage my condition with my splint and soft foods when needed. The point of my post is this: this condition is yours for a lifetime. It can get better and worse, but it will always be with you. I don't know if surgery is right for you, but don't look at it as the miracle answer to all your pain. It's been right for me and I've been happy with the results, but not everyone is. Do a lot of research and be informed. Good luck with your decision!:)
Clencher
08-13-2006, 12:51 PM
I am scheduled to have this surgery on the left side, August 30th. I too have had all the other things - splints, heat, anti-inflamatory drugs, muscle relaxers etc. and nothing worked. The condoyl is flattened out and the disc is completely off the joint. I am hopeful that this surgery will help the constant ear ache, cheek pain, neck pain etc. that I have.
When you had the surgery, was there much swelling or bruising? I bruise fairly easy because I am so light skinned. Did they wire your mouth? I am told they will not be wiring my mouth, but I am concerned that if they don't I will be right back were I am within 6 months or so. I cock my jaw out or to the side in concentration, most times I don't even relize it. I also clench and grind. I have been driving my husband crazy at night because of my snoring. I think that everything is so inflammed in that area that when I lie down I block my nose and can't breathe well. He says I am very loud and he ends up on the couch a lot lately. :(
I am a little nervous, but I have struggled for so long with this that anything has got to be a step better. Any advise on healing or whatever would be great. Thanks!
When you had the surgery, was there much swelling or bruising? I bruise fairly easy because I am so light skinned. Did they wire your mouth? I am told they will not be wiring my mouth, but I am concerned that if they don't I will be right back were I am within 6 months or so. I cock my jaw out or to the side in concentration, most times I don't even relize it. I also clench and grind. I have been driving my husband crazy at night because of my snoring. I think that everything is so inflammed in that area that when I lie down I block my nose and can't breathe well. He says I am very loud and he ends up on the couch a lot lately. :(
I am a little nervous, but I have struggled for so long with this that anything has got to be a step better. Any advise on healing or whatever would be great. Thanks!
raylp
08-13-2006, 01:53 PM
I just had a bilateral arthroscopy 2 days ago. It was performed by Dr. Allen Tarro of the Boston area. I have limited swelling, mobility has increased from 25mm to 37mm after exercising, and I am not in pain. I am still cautious, but quite thankful for this kind of success so far.
Like many of you it took me months to come to a decision about this. I'm not going to go into my full details in this post, but if you want them, look at my prior posts. What I will say is that from my perspective there is a vast difference in how the doctors and surgeons will handle the surgery, and I decided to go with the best I could find.
I wanted someone with a high success rate, high level of experience, high level of professional conduct, and also someone who was approachable, because after reading through posts here for a few months I was a wreck emotionally.
It took having to go through a journey of meeting several physicians who were not quite all of this in order to become clear on what I wanted. After learning what I had to learn, I came to the conclusion that I would travel to a great surgeon rather than compromise with a questionable local one.
For instance, one local surgeon I went to recommended open joint surgery because he said arthroscopy didn't have a good success rate in his experience. Then I found surgeons quoting 90+ percent success rates with arthroscopy.
This kind of vastly conflicting information be confusing for a patient, especially for one who wants alleviation from their suffering. The wierd thing is that there is room for all kinds, and also there are all kinds of TMJ.
My main point is that an arthroscopy procedure is not conducted the same by all surgeons, and you have to do your best to figure out which kind you want.
Some arthroscopy procedures are more complex than others. I've learned that some surgeons will bascially just flush out the joint and mobilize the discs, whereas other surgeons will do alot more. Some surgeons will use lasers, and other will not.
It can be alot of information to sort out, so the criteria I mentioned earlier can simplify this a bit. How many surgeries have they performed? Do you want someone who does 5 a year or someone who does 5 a month? Do you want someone with 20 under his belt or someone with 1000?
Also you do want references. My doctor was agreeable to this, and I talked on the phone with 2 patients who had very successful outcomes, one of whom was directed to the surgeon by another former patient who was in great shape 5 years later.
This kind of research is necessary, and you have to do it yourself, because the system is not set up so that someone else will do it for you. Thankfully we have boards like this to share and disseminate information together. Several posts on here dramatically changed the course of my journey, especially PWC's, as I was about to go to the "well respected" surgeon that gave her and others a poor surgery.
Thank you PWC, Rubato and others. It helped me make an informed decision.
Like many of you it took me months to come to a decision about this. I'm not going to go into my full details in this post, but if you want them, look at my prior posts. What I will say is that from my perspective there is a vast difference in how the doctors and surgeons will handle the surgery, and I decided to go with the best I could find.
I wanted someone with a high success rate, high level of experience, high level of professional conduct, and also someone who was approachable, because after reading through posts here for a few months I was a wreck emotionally.
It took having to go through a journey of meeting several physicians who were not quite all of this in order to become clear on what I wanted. After learning what I had to learn, I came to the conclusion that I would travel to a great surgeon rather than compromise with a questionable local one.
For instance, one local surgeon I went to recommended open joint surgery because he said arthroscopy didn't have a good success rate in his experience. Then I found surgeons quoting 90+ percent success rates with arthroscopy.
This kind of vastly conflicting information be confusing for a patient, especially for one who wants alleviation from their suffering. The wierd thing is that there is room for all kinds, and also there are all kinds of TMJ.
My main point is that an arthroscopy procedure is not conducted the same by all surgeons, and you have to do your best to figure out which kind you want.
Some arthroscopy procedures are more complex than others. I've learned that some surgeons will bascially just flush out the joint and mobilize the discs, whereas other surgeons will do alot more. Some surgeons will use lasers, and other will not.
It can be alot of information to sort out, so the criteria I mentioned earlier can simplify this a bit. How many surgeries have they performed? Do you want someone who does 5 a year or someone who does 5 a month? Do you want someone with 20 under his belt or someone with 1000?
Also you do want references. My doctor was agreeable to this, and I talked on the phone with 2 patients who had very successful outcomes, one of whom was directed to the surgeon by another former patient who was in great shape 5 years later.
This kind of research is necessary, and you have to do it yourself, because the system is not set up so that someone else will do it for you. Thankfully we have boards like this to share and disseminate information together. Several posts on here dramatically changed the course of my journey, especially PWC's, as I was about to go to the "well respected" surgeon that gave her and others a poor surgery.
Thank you PWC, Rubato and others. It helped me make an informed decision.
papergoods
08-16-2006, 03:16 AM
thank you all for this
Clencher
08-17-2006, 12:20 AM
I just had a bilateral arthroscopy 2 days ago. It was performed by Dr. Allen Tarro of the Boston area. I have limited swelling, mobility has increased from 25mm to 37mm after exercising, and I am not in pain. I am still cautious, but quite thankful for this kind of success so far.
raylp,
Did they wire your mouth shut? I am thinking that they might wire mine because I have a bad habit of cocking my jaw forward in concentration. I try to stop myself whenever I catch myself doing it, but I do in pretty much 24/7. I'm thinking they might wire it to get me out of that habit, otherwise the surgery might not help as much. What do you guys think?
raylp,
Did they wire your mouth shut? I am thinking that they might wire mine because I have a bad habit of cocking my jaw forward in concentration. I try to stop myself whenever I catch myself doing it, but I do in pretty much 24/7. I'm thinking they might wire it to get me out of that habit, otherwise the surgery might not help as much. What do you guys think?
raylp
08-17-2006, 09:04 PM
They didn't wire me up, but I didn't have any serious clenching issues. I'm not sure what they would do in your case. If you are considering traveling for a surgery, I'd call someone like Dr. Tarro and ask. In fact I'd call several top surgeons and ask. Go to the experts.
With that said, the cocking thing sounds to me like a behavorial issue that might be changed through some therapy. (maybe a shock collar :-)) I'd want to get that kind of thing addressed prior to a surgery if possible.
With that said, the cocking thing sounds to me like a behavorial issue that might be changed through some therapy. (maybe a shock collar :-)) I'd want to get that kind of thing addressed prior to a surgery if possible.
papergoods
08-18-2006, 08:43 PM
Hi...
I went for a consult for a surgery and the surgeon recommended I have my disks tied into place by tying them to the muscle. He told me that in arthroscopy, the disk can just move back to where it was out of place because there is notihing to hold it in place. My pain managment guy however said i should avoid this open joint surgery and just have the arthroscopic bec. there is no research to back up success of tying a disk anywhere. Im lost and dont know what to do.
Has anyone been to any highly recommended surgeons in California? Arizona or maybe Marland DC or Virginia
I went for a consult for a surgery and the surgeon recommended I have my disks tied into place by tying them to the muscle. He told me that in arthroscopy, the disk can just move back to where it was out of place because there is notihing to hold it in place. My pain managment guy however said i should avoid this open joint surgery and just have the arthroscopic bec. there is no research to back up success of tying a disk anywhere. Im lost and dont know what to do.
Has anyone been to any highly recommended surgeons in California? Arizona or maybe Marland DC or Virginia
raylp
08-19-2006, 01:09 PM
Avoid open joint surgery. Find an arthroscopic surgeon who does what works.
I'd approach it this way:
Find out who the top 5- 10 arthroscopic TMJ surgeons are in the country. Then go to the one that you like the most, or who is good and convenient as well.
With that said, I didn't go to that extent. I found out who I thought were the top 4 surgeons, and then went to the closest.
One way to locate great surgeons is to find one who will offer recommendations. So you ask them during an interview, who they would go to if they needed arthrscopic surgery. This is one way to whittle the thing down. Or they may even be nice enough to give you a referral just on the phone. I'd just say that I heard you were an excellent doctor, but that I really didn't want to travel that far for this particular procedure if possible. Is there someone you know of in my part of the country who has alot of experience. These guys tend to know each other through the various organizations, publications, and conferences.
Surgeons each have a particular style with which they handle discs. There are those that suture, and those that do not. But then within those categories there are various substyles. From what I gathered, it takes alot of skill to suture arthroscopically. Alot of skill. So you want to go to someone with alot of skill and experience if this is your intended route.
Dr. Tarro in Boston, who has been doing this for 15 years or more, and 1600 surgeries, uses temporary sutures inside the joint, and then makes a relaxing incision to the anterior ligament- I think I got that right.
So he relaxes the front connective tissue so that the disc doesn't get pulled forward. In the meantime the sutures are holding the disc in place. I gathered that the tissues hold the disc in place after the sutures dissolve in 3 months.
I'd approach it this way:
Find out who the top 5- 10 arthroscopic TMJ surgeons are in the country. Then go to the one that you like the most, or who is good and convenient as well.
With that said, I didn't go to that extent. I found out who I thought were the top 4 surgeons, and then went to the closest.
One way to locate great surgeons is to find one who will offer recommendations. So you ask them during an interview, who they would go to if they needed arthrscopic surgery. This is one way to whittle the thing down. Or they may even be nice enough to give you a referral just on the phone. I'd just say that I heard you were an excellent doctor, but that I really didn't want to travel that far for this particular procedure if possible. Is there someone you know of in my part of the country who has alot of experience. These guys tend to know each other through the various organizations, publications, and conferences.
Surgeons each have a particular style with which they handle discs. There are those that suture, and those that do not. But then within those categories there are various substyles. From what I gathered, it takes alot of skill to suture arthroscopically. Alot of skill. So you want to go to someone with alot of skill and experience if this is your intended route.
Dr. Tarro in Boston, who has been doing this for 15 years or more, and 1600 surgeries, uses temporary sutures inside the joint, and then makes a relaxing incision to the anterior ligament- I think I got that right.
So he relaxes the front connective tissue so that the disc doesn't get pulled forward. In the meantime the sutures are holding the disc in place. I gathered that the tissues hold the disc in place after the sutures dissolve in 3 months.
MaggieMay78
08-20-2006, 03:17 AM
raylp,
Did you have the surgery primarily for pain relief, or to help your function? I am glad to hear you are not in pain! But I have also heard that surgery should really only be used for those who have poor function. Obviously, you were having issues with function if you could only open 25mm. It apparently does help some lucky people reduce their pain...but many times, it doesn't have that effect. I was told by 3 TMJ specialists that I should never resort to surgery unless I lose a lot of function (can't open well, can't chew, etc.)
Just wondering what your thoughts are on this?
thanks,
Meg
Did you have the surgery primarily for pain relief, or to help your function? I am glad to hear you are not in pain! But I have also heard that surgery should really only be used for those who have poor function. Obviously, you were having issues with function if you could only open 25mm. It apparently does help some lucky people reduce their pain...but many times, it doesn't have that effect. I was told by 3 TMJ specialists that I should never resort to surgery unless I lose a lot of function (can't open well, can't chew, etc.)
Just wondering what your thoughts are on this?
thanks,
Meg
raylp
08-20-2006, 10:39 AM
This is an issue that I personally haven't made any conclusions on, and it is a pivotal part of the decision whether to have surgery or not.
My thoughts on this are just thoughts, and not really eductated.
1) There are alot of different kinds of TMJ. Some of these kinds are more arthritic based, in which there is some kind of degeneration. If this is the case, moving the discs might not help the pain as much.
2)Then there are the displaced TMJ types. Somehow these people got their disc disclocated. I feel that these people are better candidates for getting the disc back and functioning without pain.
This is my attempt to simplify the issue, but really there are many different shades of either.
Another thought is that I would think the cause of the TMJ would need to be resolved, because I wonder if surgery really is a solution. I know it puts the disc back into place, at least temporarily, but does it solve the issue? I don't know. That is a lingering question for me.
How can a joint pop and dysfunction and eventually displace the disc, and then suddenly get fixed by a 20 min surgery? That also is a question that I haven't answered.
I personally had to study the reasons that I had TMJ and decide if I could provide solutions for them outside of the surgery. Then the surgery was just one part of the whole.
I found that there were several causes for my TMJ.
LYME disease
long periods of STRESS
Poor Posture at the PC for long times
High intensity stress as in multiple life crises
Out of shape physically so muscles not flexible
Overdid it physically while moving in dead of winter
So once I put this list together, I decided I could provide the solutions to many of these causes before the surgery. I now get regular exercise, use stress reduction measures, know my limits, have tackled Lyme disease using alternative methods, and got some counseling to sort things out.
There are alot of opinions out there, so I just came up with my own after compiling the bunch of them. I decided that I fell into the camp of physical disclocation of disc and went for the surgery. BUT
I will reiterate a main point for me.
I would not elect to have the surgery unless I felt that the odds were solidly in my favor, as in 85% or greater. So how to improve odds?
Great Surgeon. I would not go to an average surgeon. NO WAY.
I went through a hellacious journey before I made it to Dr. Tarro. I went to several surgeons for interviews or because that's where the insurance sent me originally, that I would NOT ever trust my future health to. They may act nice enough, but it comes down to experience and % success rate, references, and well how you feel with the surgeon.
I ended up going to a different surgeon than was recommended by my specialist, my dentist, (each had a different opinion) and my insurance (they didn't have a qualified local one, so I argued for an experienced out of state one) I had to do this by myself and so do most TMJ sufferers because of how few surgeons, in my opinion, are worth the risk.
You know it came down to accumulating data. I talked to everyone I could find, TMJ physical therapists, TMJ specialists, TMJ surgeons, TMJ patients; then read everything I could as in Healthboards, articles, journals, etc.
I think this is the reality of TMJ. This is not a specialization that is as developed as others such as knees, etc. Insurance doesn't cover it as much, so basically there isn't as much $$ out there for the field. So the best surgeons will likely be not in states that have no insurance coverage, but in states where the money is flowing and the experience is there.
It sucks, but it is the reality. (I think)
My thoughts on this are just thoughts, and not really eductated.
1) There are alot of different kinds of TMJ. Some of these kinds are more arthritic based, in which there is some kind of degeneration. If this is the case, moving the discs might not help the pain as much.
2)Then there are the displaced TMJ types. Somehow these people got their disc disclocated. I feel that these people are better candidates for getting the disc back and functioning without pain.
This is my attempt to simplify the issue, but really there are many different shades of either.
Another thought is that I would think the cause of the TMJ would need to be resolved, because I wonder if surgery really is a solution. I know it puts the disc back into place, at least temporarily, but does it solve the issue? I don't know. That is a lingering question for me.
How can a joint pop and dysfunction and eventually displace the disc, and then suddenly get fixed by a 20 min surgery? That also is a question that I haven't answered.
I personally had to study the reasons that I had TMJ and decide if I could provide solutions for them outside of the surgery. Then the surgery was just one part of the whole.
I found that there were several causes for my TMJ.
LYME disease
long periods of STRESS
Poor Posture at the PC for long times
High intensity stress as in multiple life crises
Out of shape physically so muscles not flexible
Overdid it physically while moving in dead of winter
So once I put this list together, I decided I could provide the solutions to many of these causes before the surgery. I now get regular exercise, use stress reduction measures, know my limits, have tackled Lyme disease using alternative methods, and got some counseling to sort things out.
There are alot of opinions out there, so I just came up with my own after compiling the bunch of them. I decided that I fell into the camp of physical disclocation of disc and went for the surgery. BUT
I will reiterate a main point for me.
I would not elect to have the surgery unless I felt that the odds were solidly in my favor, as in 85% or greater. So how to improve odds?
Great Surgeon. I would not go to an average surgeon. NO WAY.
I went through a hellacious journey before I made it to Dr. Tarro. I went to several surgeons for interviews or because that's where the insurance sent me originally, that I would NOT ever trust my future health to. They may act nice enough, but it comes down to experience and % success rate, references, and well how you feel with the surgeon.
I ended up going to a different surgeon than was recommended by my specialist, my dentist, (each had a different opinion) and my insurance (they didn't have a qualified local one, so I argued for an experienced out of state one) I had to do this by myself and so do most TMJ sufferers because of how few surgeons, in my opinion, are worth the risk.
You know it came down to accumulating data. I talked to everyone I could find, TMJ physical therapists, TMJ specialists, TMJ surgeons, TMJ patients; then read everything I could as in Healthboards, articles, journals, etc.
I think this is the reality of TMJ. This is not a specialization that is as developed as others such as knees, etc. Insurance doesn't cover it as much, so basically there isn't as much $$ out there for the field. So the best surgeons will likely be not in states that have no insurance coverage, but in states where the money is flowing and the experience is there.
It sucks, but it is the reality. (I think)
navymid
08-22-2006, 12:00 PM
I have quite different opinions than some people. I am a BIG advocate of the open joint procedure. I hurt my jaw about a year ago and had 3 arthrocentesis which did absolutly nothing. I then had one arthroscopy which worked for about a month. My disc was severly displaced and torn ligaments. The arthroscopy moved the disc back into place, but it came back out shortly after I began heavy workouts again.
Then I had open joint and my jaw has never felt this good since the injury. I had a mitek anchor put in to permanently hold the disc. I still have minor pains, especially when chewing hard foods, but nothing nearly as bad as it was.
Problem now is that my other side is hurting bad. It was also injured, but not as bad as the left side. The surgeons tried one arthrocentesis on it, but it did nothing. Who knows what is going to happen to that side now...
Overall, I would go for the open joint if I were you. I have had good results from it. There is a lot of PT involved with recovery, but to me, it is very worth it to not be in pain anymore.
Then I had open joint and my jaw has never felt this good since the injury. I had a mitek anchor put in to permanently hold the disc. I still have minor pains, especially when chewing hard foods, but nothing nearly as bad as it was.
Problem now is that my other side is hurting bad. It was also injured, but not as bad as the left side. The surgeons tried one arthrocentesis on it, but it did nothing. Who knows what is going to happen to that side now...
Overall, I would go for the open joint if I were you. I have had good results from it. There is a lot of PT involved with recovery, but to me, it is very worth it to not be in pain anymore.
raylp
08-22-2006, 12:06 PM
Wow. It surprises me to hear that you had a good experience with open-joint and recommend it. I am amazed at all the different ways something can be done, and positive results reached.
A few questions:
What success rates did your surgeon say they had? What is the long-term prognosis of the mitek anchor?
Also how long ago did you do this?
Did the same surgeon do the different surgeries?
Why did they do 3 arthrocenteses on the same joint?
With this said, you're not actually recommending avoiding arthroscopy and going straight to open joint are you, given the postitive statistics (at least in medical journals) of arthroscopy?
A few questions:
What success rates did your surgeon say they had? What is the long-term prognosis of the mitek anchor?
Also how long ago did you do this?
Did the same surgeon do the different surgeries?
Why did they do 3 arthrocenteses on the same joint?
With this said, you're not actually recommending avoiding arthroscopy and going straight to open joint are you, given the postitive statistics (at least in medical journals) of arthroscopy?
Clencher
08-22-2006, 04:47 PM
I just spoke with my doctor's office again. I was wrong on the name of the procedure. The doctor's nurse said it is an arthroscopic arthroplasty. She said it would be done with the smallest incision possible. Is this surgery different then what you guys had or do some doctors just call it a different name? I am getting nervous as the days fly quickly and the surgery day (Aug. 30) gets closer. However, I am ready for relief and so hopeful that it will come in the weeks following surgery.
raylp
08-22-2006, 06:19 PM
Arthroscopic arthroplasty. hmm sounds like they open the joint up, but use a smaller incision than a standard arthroplasty.
A TMJ Arthroscopy is where they make a few punctures in the skin and insert small arthroscopic tools into them. The incisions are 3/4 of an inch I believe.
Arthroplasty is open joint, and I think the incision is about 3 inches long.
If the surgery is a hybrid of the two, I would think they open the joint up a bit more than just arthroscopy, but less than arthroplasty.
The issue of incision size has to do with recovery time and possibly internal scar volume, as well as cosmetic scars on the outside.
Once you've deliberated fully on the pros and cons of surgery, and made a decision to go for it, I think the next step is to find a surgeon with a proven track record. Some are willing to provide references, etc. That's all part of the research phase. If you didn't do complete research prior to making the appointment, I'd do it now.
Things to ask:
How many of these procedures they have done
What the success rate is
If you can talk to former patients to see how it went for them
The details of the procedure
The typical recovery
Why the surgeon does this particular procedure versus the other forms
Failure rate
Redo rate
Etc.
I looked back at your posts and you mentioned a flattened condoyle. I'm not sure if they repair condoyles and bones in the TMJ joint with pure arthroscopy, so that may explain why they need to open the joint enough to get to this. That would make sense.
A TMJ Arthroscopy is where they make a few punctures in the skin and insert small arthroscopic tools into them. The incisions are 3/4 of an inch I believe.
Arthroplasty is open joint, and I think the incision is about 3 inches long.
If the surgery is a hybrid of the two, I would think they open the joint up a bit more than just arthroscopy, but less than arthroplasty.
The issue of incision size has to do with recovery time and possibly internal scar volume, as well as cosmetic scars on the outside.
Once you've deliberated fully on the pros and cons of surgery, and made a decision to go for it, I think the next step is to find a surgeon with a proven track record. Some are willing to provide references, etc. That's all part of the research phase. If you didn't do complete research prior to making the appointment, I'd do it now.
Things to ask:
How many of these procedures they have done
What the success rate is
If you can talk to former patients to see how it went for them
The details of the procedure
The typical recovery
Why the surgeon does this particular procedure versus the other forms
Failure rate
Redo rate
Etc.
I looked back at your posts and you mentioned a flattened condoyle. I'm not sure if they repair condoyles and bones in the TMJ joint with pure arthroscopy, so that may explain why they need to open the joint enough to get to this. That would make sense.
papergoods
08-23-2006, 05:43 AM
Navymid...when they inserted your anchors, did they break your jaw mandible bone and move it forward? the doc who I consulted suggested breaking the mandible and moving it forward, that part scared me.
I have quite different opinions than some people. I am a BIG advocate of the open joint procedure. I hurt my jaw about a year ago and had 3 arthrocentesis which did absolutly nothing. I then had one arthroscopy which worked for about a month. My disc was severly displaced and torn ligaments. The arthroscopy moved the disc back into place, but it came back out shortly after I began heavy workouts again.
Then I had open joint and my jaw has never felt this good since the injury. I had a mitek anchor put in to permanently hold the disc. I still have minor pains, especially when chewing hard foods, but nothing nearly as bad as it was.
Problem now is that my other side is hurting bad. It was also injured, but not as bad as the left side. The surgeons tried one arthrocentesis on it, but it did nothing. Who knows what is going to happen to that side now...
Overall, I would go for the open joint if I were you. I have had good results from it. There is a lot of PT involved with recovery, but to me, it is very worth it to not be in pain anymore.
I have quite different opinions than some people. I am a BIG advocate of the open joint procedure. I hurt my jaw about a year ago and had 3 arthrocentesis which did absolutly nothing. I then had one arthroscopy which worked for about a month. My disc was severly displaced and torn ligaments. The arthroscopy moved the disc back into place, but it came back out shortly after I began heavy workouts again.
Then I had open joint and my jaw has never felt this good since the injury. I had a mitek anchor put in to permanently hold the disc. I still have minor pains, especially when chewing hard foods, but nothing nearly as bad as it was.
Problem now is that my other side is hurting bad. It was also injured, but not as bad as the left side. The surgeons tried one arthrocentesis on it, but it did nothing. Who knows what is going to happen to that side now...
Overall, I would go for the open joint if I were you. I have had good results from it. There is a lot of PT involved with recovery, but to me, it is very worth it to not be in pain anymore.
navymid
08-23-2006, 10:34 PM
raylp--
In answer to your questions, my surgeons had really not done these procedures very much(military docs-- they say they dont see this a lot). However, with that said, my main surgeon had done this procedure 10 times maybe.
As far as the mitek anchor, they said it should last life time if I don't injury my jaw again. They said if I took a hard blow to the jaw again, then the disc may come back out of place. They did not break my jaw, but they did mention that option to me. Instead, they drilled a hole in the back of my condyle and inserted the anchor. Also, they smoothed the top of the condyle down. The incision they made is about 6 inches long. It is hidden very well. They cut above my ear several inches and then cut down inside my ear. The only noticible part is from my ear to my head, but my hair covers most of it and nobody really notices unless I point it out.
I had a different combination of surgeons for all surgeries. One doc was there for 2 of them, one for 3, and another for 2. I got thrown around from doc to doc and each of them wanted to start with an arthrocentesis everytime, so that is why I had 3. None of them worked....
No, I would not recommend skipping arhtroscopy, but in my case, open joint was a miracle. I just had it done April 25th and I was eating most everything by 2 months out. I really think the kinds of surgeries that work depend on the type of injury.
In answer to your questions, my surgeons had really not done these procedures very much(military docs-- they say they dont see this a lot). However, with that said, my main surgeon had done this procedure 10 times maybe.
As far as the mitek anchor, they said it should last life time if I don't injury my jaw again. They said if I took a hard blow to the jaw again, then the disc may come back out of place. They did not break my jaw, but they did mention that option to me. Instead, they drilled a hole in the back of my condyle and inserted the anchor. Also, they smoothed the top of the condyle down. The incision they made is about 6 inches long. It is hidden very well. They cut above my ear several inches and then cut down inside my ear. The only noticible part is from my ear to my head, but my hair covers most of it and nobody really notices unless I point it out.
I had a different combination of surgeons for all surgeries. One doc was there for 2 of them, one for 3, and another for 2. I got thrown around from doc to doc and each of them wanted to start with an arthrocentesis everytime, so that is why I had 3. None of them worked....
No, I would not recommend skipping arhtroscopy, but in my case, open joint was a miracle. I just had it done April 25th and I was eating most everything by 2 months out. I really think the kinds of surgeries that work depend on the type of injury.
Clencher
09-04-2006, 12:45 PM
Surgery went well. I have an incission of about 3 inches just in front of my ear and the rest is inside my ear. I have had some swelling and a little yellow bruising under my eye. They did not have to do a muscle graft. They did put in two mitek achors. They said my disc was still in pretty good shape. The first day wasn't bad, then the swelling started. The 3rd day I didn't eat enough and got nauseated. I have a little of anxiety so I begin to have a little of an attach thinking about the possibility of throwing up. But, I got it under control and made myself eat some broth to get rid of the nausea and be able to take a pain pill. I haven't had much pain in the last several days, mostly discomfort. I go back to the doctor to remove the stitches on Wednesday.
Any ideas about something different to eat? I've got another 10 days of liquids and I'm already tired of the same old thing. I've eaten cream soups, applesauce thinned w/ juice, some baby foods (mostly fruits), V-8 juice, really creamy yogurt thinned with milk, pudding thinned with milk, melted jello, and fruit juices. I tried cream of wheat thinned with w/ milk and didn't like it at all.
On the brighter side, I need to loss about 50 pounds and this will for sure get me started! So, despite everything else that will be great.:) Thanks for your thoughts and prayers.
Any ideas about something different to eat? I've got another 10 days of liquids and I'm already tired of the same old thing. I've eaten cream soups, applesauce thinned w/ juice, some baby foods (mostly fruits), V-8 juice, really creamy yogurt thinned with milk, pudding thinned with milk, melted jello, and fruit juices. I tried cream of wheat thinned with w/ milk and didn't like it at all.
On the brighter side, I need to loss about 50 pounds and this will for sure get me started! So, despite everything else that will be great.:) Thanks for your thoughts and prayers.