Hi there -
I've been in 2 MVA's in a year and a half and have some nasty TMJ dysfunction and constant pain. After a year and a half of minimally successful physio and massage therapy, my dentist is starting to give me the sell on TMJ arthroscopy by saying it's "minor" surgery. I need to do research on this and would LOVE to hear anyone's personal experiences with TMJ arthroscopy, good or bad, risks and benefits. Please, any help would be most appreciated -- I am quite concerned and scared of this, however "minor" it may be for my dentist, because any jaw surgery isn't "minor" to me.
I had bilateral tmj arthroscopy surgery in 1995. In conjunction with the surgery wore a Herbst appliance, physical therapy, orthodontics, etc. Recovery period was 1 year with 6 months liquid folowed by 6 months no chew diet. Before going for the surgery had several years of splint therapy.
My tmj displacement was relatively mild at the time. If a couple of dentists hadn't used the wrong type of splint, surgery could have been avoided altogether.
Yes, the arthroscopy could be considered minor as opposed to something like total joint replacement.
I followed instructions to the letter for a good recovery. The surgery worked! For about 6 months I thought my problem was completely solved! I was so happy! In my case had blunt trauma to the joint. Surgeon said another surgery could fix it. Enough of me...if you are considering this the main point to remember is you really only get one shot at this for best results. If something goes wrong during or after you will be much worse off. Be very sure of the surgeon you pick and be prepared for much time and effort. I am in very serious pain right now and will need surgery if possible but I actually believe in this procedure. From other posts I have read and research it seems that even in the best of circumstances the surgery does not last sometimes, and creates the need for multiple surgeries.
You do not say what area of the country you live in? What other treatments have you tried? Must run for now...let me know if you want any further info about this.
When it comes to TMJ surgery - nothing is MINOR and don't let some stupid surgeon tell you otherwise. Anytime you go into that joint you run the very high risk of creating scar tissue which will further cause injury to the joint and pain to you. Even arthrocentethis is invasive and painful. I am not saying don't do it, but don't let the surgeon minimize it to you. I am sure if it was his joint someone wanted to go into, he would think long and hard about it. He KNOWS the risks and the percentages of failures. He won't admit them to you. He thinks all of his surgeries are successes - chances are good his failures have moved on to another doctor because he made them worse.
I have had this surgery as well and would, be no means, label it "minor". It is, however, easier to recover from than the other tmj surgeries. You didn't mention what problems you are having. What are they hoping to accomplish with this surgery? Do you have displaced discs or is it something else? I have found that each case is completely different and what is good for one person is not good for the next. I had this surgery and had 9 pain free years afterwards. I am now having a more invasive surgery. So, I would say mine was successful and worth it. I do not feel that having one surgery always leads you to a lifetime of surgeries. I think it depends on the problem you are having. I have completely shredded discs and keeping them isn't an option anymore. So, to finally wrap this up, I think that surgery is worth it for some people, and not others. It just depends on what issues you are dealing with and what they hope to accomplish with the surgery. Sorry I rambled on so much and good luck in whatever decision you make.
You said your "Dentist" have you had a counsultation with an Oral Surgeon who specialty is TMJ? I had arthroscopy within my left and right joints in March of 1999 and did get some relief for about two months. I hope if you do go through with the surgery you allow someone who specilizes in TMJ to perform it. If you decide to go through with it ask the OS who is going to operate on you for phamplets and other information regarding the surgery. Ask what the positives and negatives are for YOU if you do or do not have the surgery. Most of all speak up and ask questions. If I have learned ANYTHING at all during this life altering ordeal it is, this is YOUR BODY and YOUR LIFE, ASK QUESTIONS! Do not be afraid, this is YOUR BODY and you have the right to know. Second is, check out the OS. Get a second, third opinion. And at any time if you are uncomfortable speak up!
I wanted to reply to TMJ arthroscopy. I had a bilateral TMJ arthroscopy in October 2004. I have been unable to chew even the most soft food since then. I started to lose 10 pounds per week until I realized I had to literally drink all the calories I would need to survive. My jaw deviated and I lost what once was a perfect bite. I am so sorry I had this surgery. It was a complete failure. I am still in constant pain in my jaw joints and have new pain around my jaw line which I never had before. A facial nerve was damaged during the surgery resulting in loss of movement in my lips. I have been loyal to my physical therapy regimine and still may have developed scar tissue. The opening that I got from the surgery to move the disc(s) back onto the condyle was not enough to warrant the surgery. I could have attained more mm on the opening with a conservative physical therapy regimine and no surgery. I would give ANYTHING to go back in time to the day before the surgery. I literally traded in ONE problem for a hosts of problems. What my body could have adapted to naturally with the TMJ disfunction now cannot adapt because of the aggressive surgical intervention. I did not think a minimally invasive procedure like the arthroscopy would have been so damaging. You must EXHAUST all CONSERVATIVE methods before resorting to surgery. I wish I had. Unfortunately, my surgeon was an aggressive salesman. He was attentive pre-surgery and is evasive and hard to find post-op. I DO NOT endorse any type of surgery to the TMJ. It is too complex a joint. The surgeon, no matter how skilled, cannot repair, replace, move, shave, flush... any part of the TMJ, to "fix" your problem as the jaw joint is capable of various ranges of motion and within those ranges, many more. Even with the arthroscope, the surgeon cannot restore your natural mobility in your jaw joint. Think of this: even the most experienced orthopedic surgeon will not operate on your jaw joint. He/She will operate on your knee, elbow, shoulder, ankle, hip... BUT He/She will not touch the jaw joint. Why? Please reflect on this and think about it. Had someone said this to me, I would NOT have had my surgery. Again, the jaw joint is very, very complex.
Great now I am freaked out! I am getting this surgery done in two weeks! But, I have tried everything else. My wedding is in sept and I cant stand to think I wont be able to eat at my wedding! My doctor called it a tmj scope.. Is this the same thing?! From my understanding it wouldnt take that long to heal!! My pre-op is friday so I will have some major questions to ask the doctor. He is a specialist and has done a lot of these procedures. He works at the U of Mn twin cities dental school, so I hope he is good at this and doesnt let some intern preform it on me!!
if your surgeon refers to it as a "scope" it is most probably an arthroscopy. the healing process involves the swelling going down in the joints that results from both the trauma of the surgery and the fluids injected into the upper and lower portions of the joint. are you having one side done or both? will your surgeon suture your disc(s) back into place? is he using a laser or a trocar to break up any adhesions in the joint? from posting questions to others who had this done (as i did) i feel the suturing of the disc (in my case) has lead to my decreased function and increased pain and the use of the laser (in my case) lead to the rapid development of scar tissue because of the heat of the laser. if you decide to get the surgery have intraoral photos of your occlusion taken and try to get models made of your teeth. your occlusion (your bite) may change after the surgery. if your bite is o.k. now and is not contributing to your tmjd, then you'd want to get your bite back if it is thrown off. i'd also advise that you scan these posts (this board) and write down questions/concerns for your surgeon to answer at your pre-op. good luck. all the best with your wedding.
If you've tried everything else, it's probably best. pwc is right though. Be as informed as you can be. And, I do think the suturing of the discs is a bad idea. I had this surgery so long ago, I can't remember how long I couldn't chew. But, you should be okay by your wedding. Good luck and congratulations. I hope everything goes well for you.
Unfortunately, my surgeon was an aggressive salesman. He was attentive pre-surgery and is evasive and hard to find post-op. I DO NOT endorse any type of surgery to the TMJ. It is too complex a joint. The surgeon, no matter how skilled, cannot repair, replace, move, shave, flush... any part of the TMJ, to "fix" your problem as the jaw joint is capable of various ranges of motion and within those ranges, many more. Even with the arthroscope, the surgeon cannot restore your natural mobility in your jaw joint. Think of this: even the most experienced orthopedic surgeon will not operate on your jaw joint. He/She will operate on your knee, elbow, shoulder, ankle, hip... BUT He/She will not touch the jaw joint. Why? Please reflect on this and think about it. Had someone said this to me, I would NOT have had my surgery. Again, the jaw joint is very, very complex.
Excellent summation, pwc.
There is help & hope with the proper treatment.
Before you put "your's" in a surgeon's hands, try everything else possible and then, TRY AGAIN.
Hello everyone, Well I got the arthroscopy one week ago. The surgery went well, the pain I had when ever I opened my mouth is not present at this time. It seems wonderful for now! I go to PT 3 times per week and my Therapist says I am healing really well!! I do have some tenderness at times, but I think its due to PT. My doctor said I can eat what ever I want, he says its good to chew and use my jaw. I have had no problem chewing at all. I am staying away from hard stuff though. I had a lot of swelling in the jaw joint, that is what was causing the pain. For the first 48 hours after the surgery I kept my 'Jaw Bra' on and kept ice on it. I really didnt have any swelling on my face, I was scared I would have a fat face for a while. lol
For now I feel great, who knows what the future will hold but I believe this procedure was a great success for me.
I realize this thread is.. kind of old (about two months) but I figured I would try my luck and post here anyway..
I'm going through this Arthroscopy myself at the end of the week, but I am very up in the air. I don't feel I have covered all of my "conservative" methods, as it is very hard to find someone speciailized in TMJ. Though, the surgeon performing the surgery is a TMJ specialist at U of Penn.
Anyway, a lot of what was mentioned seemed like a lot more complicated surgeries then what was told to me by my doctor. he said they're going in with a scope, washing out the joint, then adding in a lubricant and thats it. Nothing was mentioned about PT or any sort of jaw restraint. Are these common after surgery things? I ask because I am on a time limit.. I leave for college in August and it is not close to where I currently live (NJ to MI).
Plus, I don't like some of the risks. I have two (he said two, but I think only one) disk out of place, so I'm really debating on how much I need this surgery.
Any help would be appreciate, I appologize for the extremely long post. Thank you very much!!
what i think you are planning to have (or what you are describing) is arthrocentesis. i do not believe that the pressure from flushing out the joint (at least in the case of your one, possibly two displaced discs) will actually allow the discs to move freely again. i have heard that this sometimes does, in fact, occur. this would be the goal. this would be ideal. this though, is a surgical procedure. having had a surgery that left me far worse off than i was with a compromised jaw, i have to tell you - i am anti-surgery. this surgery has tamed me and has taught me to be cautionary and conservative. with arthrocentesis, you WILL have residual swelling simply from the fluids your surgeon will use to flush your joints out and with the addition of other solutions he may introduce to the joints. my surgery was also supposed to be minimally invasive but it introduced a host of other more serious problems. having stated yourself that you have not EXHAUSTED conservative treatments, if i may be so bold, i implore you to do so - you would be making a wise decision. please look into splint therapy. you also stated you have a "time limit." again, i caution you, never, never make any hasty decisions regarding your health - especially when it concerns surgery. i did that. i literally rushed into surgery and am paying a high price for a hastily made decision.
I saw that you mentioned that it is not a good idea to have your disc sutured into place. I was wondering why you thought this. I had this done during arthroplasty a year ago. The surgery was a disaster and I have been in pain ever since. I am trying to figure out why the surgery was a failure. What happens when the disc is sutured into place? If you could elaborate I would appreciate it. I am meeting with a lawyer this week as I am trying to sue my surgeon for malpractice (its a long ugly story). BTW, I am very anti-surgery too after 4 failed surgeries.
regarding the disc(s) being sutured into place: by speaking with people on this board (especially rubato) and reading their histories and asking them detailed questions, i was able to make comparisons on what was done and why i was not healing. my surgeon sutured my disc into place. only after it was sutured did i realize how much the disc moves and how much it needs to move in order for there to be good mobility in the jaw. you know, when the jaw moves on some movements like wide yawns, and laterals it almost "unhinges" itself. this is normal. my disc being sutured on the right really leaves me with very little (hardly any) mobility. i have to force my jaw to move and i am either going to break the suture or i will tear the disc. it's one or the other. the suture is very, very strong. it will take alot of force to break it. the disc is very strong. it will take alot of stress to tear it. however, the disc still wants to move when i want to open my jaw. it wants to function normally and it can't because it is tied. i asked a doctor had my surgeon just moved it back over the condyle without suturing it into place, would it have stayed there. this doctor said no - the ligaments were probably too stretched out to hold the disc in place. i also think my surgeon placed my disc too far back posteriorly. he did this because he said he was trying to avoid having the disc slip out of place again. well, that's all well and good but #1 - the disc isn't where it was meant to be #2 - the disc is in a place arbitrarily chosen by the surgeon not anatomically ideal and #3 - it's just too far back, sutured and cannot move fluidly over the condyle. all this causes unbelievable tightness, stress, forceful pulling which leads to pain. funny, even with a perforated disc on the left, my left side still can move and the right wants to keep up with it but it literally cannot as the disc is held into place. va-gal, if you have not done so yet, please search this board using the key words like "sutured", "sutured into place", "disc", "discectomy"...and you will see other people who had total discectomies and/or whose discs were not sutured and they are doing far better than i am. the only reason i can see is that my disc was sutured. i sympathize with you. you have gone through alot after 4 surgeries. i know you tried your best to tame the beast but found it to be the boss. a word of advice re: malpractice - get all your ducks in a row, get every x-ray, photo, doctor's report, letter, test result, document, that pertains to you and your jaw. tmj malpractice cases are notoriously difficult and i wish you well. if i can help you or if you want to ask any other questions about the suture i have - pls. don't hesitate. you can always find out the manufacturer of the suture and ask them questions. i know i did.