Joint Replacement - TMJ Disorder -TemporoMandibular Joint Message Board

Elaine · 03-25-2003, 09:48 PM

If you try to replace a TM Joint with a synthetic device without first balancing the jaw by balancing the occlusion, you are only inviting trouble. There is an old cliché that is a part of a doctor's rule in adjusting occlusion: “When muscle and bone get into a war (conflict), muscle always wins.” There is not doubt about this. This why TM joint implants get shoved into the head so to speak. There is a new TMJ implant (FDA approved), that is rigidly attached to the ramus (the part of the jaw that is hold the condyles), that replaces the condyle. The socket is replaced with a rigidly secured fuss, both made of metal. The muscles of mastication can move the fossea and reshape the mandible over time muscle always win. Because clenching causes the need for joint replacement, clenching will destroy the synthetic joint in time. If the clenching could be stopped or the jaw could be balanced, the synthetic joint might work. But, it would better if the jaw was balanced before joint replacement to make sure that the body could not restore health.

The problem is, that most surgeons don't know how to balance a jaw in the first place. But surely, a jaw that was giving problems because of clenching trauma on an unbalanced-occlusion, cannot be happy with a synthetic joint. TMJ pain could be even worse.

When we compare the replacement of say a hip joint with a TM Joint, there is no comparison. The hip will work most of the time because the hip-joint is not over worked, but the TM joint won't work because it will be over worked via clenching. The clenching won't stop until the jaw is balanced. A TM joint replacement will not in itself, balance the jaw, which was the problem in the first place. So, beware of joint replacement.

Carey · 03-25-2003, 11:51 PM

Hi Elaine,

good to see you are back on this board. i haven't checked this site for a very long time. how are you going?

My tmj update: well i finally found a great surgeon who i trust and who has done many surgeries of my type. so in january i had tmj arthroscopy to remove debri from my joint as well as scar tissue but once he was in there the scope was faulty and would not work. the surgeon tried for an hour to try to get it work but no go. so he couldnt do anything, not even remove any of the debri. i was in absolute agony and could not even manage liquids as moving my lips was just so painful, but you would know the story.

I am scheduled to have another scope done and this time it better work, it has to and hopefully i will come out better and maybe i will be able to un lock my jaw.
can you believe it has been 3 years that my jaw has been locked shut with an opening of still 5mm?

Take care,

Carey

Cymy Sue · 03-26-2003, 03:16 AM

Hi Elaine,
This is a wonderful explanation of synthetic joint replacement. Have you read anything about a complete replacement prosthesis, that's supposed to be an exact replica of your original TMJ "apparatus" (for lack of a better word) from ear to ear? Both were offered to me a few years ago by a very aggressive surgeon, the latter at that time, still in the "experimental" category. I was told I would possibly have better function, but could have an increase in pain, so I declined. I have not really researched any of this stuff in a while and as you know, was told about 6 months ago, I was not a good candidate for any of these procedures due to prior surgical damage.

I was just curious about what types of implants and prosthesis they are doing now.

Also, I wanted to ask if you think there is anybody "out there" that truly has had good and lasting results with any of these procedures, including the Arthroscopic surgeries.

Your explanation makes a lot of sense. I've wondered for a long time if we are a small group who have had bad experiences with surgery or if the TMJ is a joint that is not understood and cannot be "fixed" surgically.

I was under the impression before I found this board, that those of us who had surgeries in the 80's & 90's were the "lab rats" and by now these procedures would be working. It appears from most current posts, these people are having the same problem. One surgery leads to another and another and..........

Do you think these Surgeons believe they can fix this joint?
Why do they keep doing these "Scope Procedures" that give a couple of years of relief for most?

And again, are we a minority? Do these procedures really work for some?

Have you seen any statistics on successes?

Glad you're posting again,
Cymy Sue

autumn83175 · 03-26-2003, 05:31 AM

Sue,

I am scheduled for bilateral joint replacements tomorrow. I am getting TMJ IMPLANTS, INC custom made total replacements. They have a pretty nice website with lots of information. There is also a site for TMJ Concepts, another commonly used replacement. I recently found a site for a northeastern US university hospital, I believe it is using a type called the Hoffman model. I have been searching for at least two years on statics or numbers and I have never foung them. I doubt you will for several years because they just recently started keeping hard data about people who have had this procedure and the results. I am part of a study group myself.

My doctor has done about 28 replacements, some one side, some both. He says all his patients are functioning and most are better. He has had two cases where there was nerve damage and they patients could not wrinkle their forehead. This was the only extent of damage he claims to have seen from joint replacement. He says he has not had any problems with loose screws or other failures of the joints. I doubt he would lie about that because it would give me grounds to sue him if I had a problem because he would have given me insubstantial information. Of course not all doctors are equally talented or honest as we have all seen plenty of times on this board.

I am very happy that I finally met someone this weekend who had exactly what I am having done. She had the sagitaril (sp) split and joint replacements ten years ago. She said she had alot of pain after the surgery. She said eventually everything healed and the pain subsided and she hasn't had any problems since. She is living a normal happy life. I needed to hear that. If you search for answers online only, you will find informative sites and people discussing the failure of thier implants. People who feel good are not posting on any site I have found. I hope to be the first

.

My doctor is rebulding everything so that it is properly aligned and back where it should be before my trama and damage occured. He is also doing extensive surgery to correct any malformities I had that contributed to my joints degenerating. I think that is important as Elaine said because if you don't fix the original problem, you would be right back at square one ten years later. I decided to have the surgery because I cant do much with what I have. To use my doctors words, I have the joints of a 90 years old lady. I am 27. Good luck with your research. I will post after my surgery and let you know how I make out either way.

Autumn

Cymy Sue · 03-26-2003, 06:41 AM

I wish you the best.

Cymy Sue