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Zhonghua Kou Qiang Yi Xue Za Zhi =... Dec 2006To investigate the patterns of condylar fractures associated with temporomandibular joint ankylosis (TMJA) and treatment methods and results based on the different types...
OBJECTIVE
To investigate the patterns of condylar fractures associated with temporomandibular joint ankylosis (TMJA) and treatment methods and results based on the different types of ankylosis.
METHODS
Forty-two joints of ankylosis in 31 patients with were categorized to four groups according to Sawhney's classification and undergone surgical treatment as follows: a joint release and disc reposition for Type I ankylosis, a dissection of bony block and disc reposition for Type II; a dissection of full-joint and employment of the temporal myofascial flap as interposition for Type III; a radically dissection of full joint followed by ramus distraction osteogenesis and genioplasty for Type IV. All of patients were followed up for 9 to 54 months with an average of 30 months. The range of mouth opening and temporomandibular joint (TMJ) function were assessed. Condylar fractures were retrospectively investigated on the patterns and the course of ankylosis development. Macroscopical visualization on the osseously ankylosed sites and disc displacement were analyzed in comparison with the radiological findings.
RESULTS
Condylar sagittal and comminuted fractures were most susceptible to TMJA. Early fibrous ankylosis occurred usually at the 4th or 5th month post-traumatically with an average month opening of 18.3 mm. The articular discs were found displaced in all cases and early bony bridge formed at a limited area where there was no disc as cushion. During fellow-up, considerable improvement in mandibular movement was attained with a stable joint function and mouth opening range of over 30 mm except for two cases in which ankylosis relapsed.
CONCLUSIONS
Condylar sagittal and comminuted fractures are most likely to cause ankylosis. Early surgical intervention could reduce the disc and avoid the later ankylosis.
Topics: Adolescent; Adult; Ankylosis; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Male; Mandibular Condyle; Mandibular Fractures; Middle Aged; Temporomandibular Joint Disc; Temporomandibular Joint Disorders; Young Adult
PubMed: 17349199
DOI: No ID Found -
Journal of Stomatology, Oral and... Dec 2021The literature lacks evidence about activity of masseter and anterior temporalis muscles in temporomandibular joint ankylosis (TMJA) patients. The purpose of this study...
PURPOSE
The literature lacks evidence about activity of masseter and anterior temporalis muscles in temporomandibular joint ankylosis (TMJA) patients. The purpose of this study was to evaluate longitudinal electromyography (EMG) changes in masseter and anterior temporalis muscle before and after gap arthroplasty in unilateral TMJA patients. Specific aim was to investigate the EMG activity restoration to the level of non-ankylosed side after arthroplasty.
METHODS
The investigator implemented a prospective longitudinal study amongst TMJA patients treated with gap arthroplasty. EMG of masseter and anterior temporalis were recorded bilaterally on ankylosed and non-ankylosed side. EMG signals of masseter and anterior temporalis were recorded preoperatively and 1 week, 3 month and 6 month postoperatively at rest and at maximum voluntary clench (MVC).
RESULTS
The study sample was composed of 16 (male:female = 1:1.28) unilateral TMJA patients. The mean duration of ankylosis was 3.25 ± 1.18 years. The difference in EMG root-mean-square (RMS) values of ankylosed side when compared to the preoperative values of non-ankylosed side was found to be statistically significant (p < 0.001) preoperatively, 1 week and 3 month postoperatively, while it was statistically not significant (p > 0.99) at 6-month postoperatively.
CONCLUSION
The present study concludes that the TMJA patients have hyperactivity of masseter and anterior temporalis muscle. Restoring the function causes the muscle activity to progress to the values of normal side. EMG activity as measured on follow-up may be one of the predicting factor for re-ankylosis.
Topics: Ankylosis; Arthroplasty; Female; Humans; Longitudinal Studies; Male; Prospective Studies; Temporal Muscle; Temporomandibular Joint
PubMed: 33031952
DOI: 10.1016/j.jormas.2020.09.015 -
Investigative Radiology Apr 1987Hand and wrist radiographs of 203 patients with rheumatoid arthritis were examined for bony ankylosis. Forty-eight patients (23.6%) showed ankylosis, including 34 with... (Comparative Study)
Comparative Study
Hand and wrist radiographs of 203 patients with rheumatoid arthritis were examined for bony ankylosis. Forty-eight patients (23.6%) showed ankylosis, including 34 with more than one joint fused. The distribution of ankylosed joints was 32.4% midcarpal, 29.5% common carpometacarpal, 15.8% radiocarpal, 15.8% proximal interphalangeal, and 6.5% metacarpophalangeal. Patients with ankylosis had significantly higher radiographic erosion, joint space narrowing, and malalignment scores than those without ankylosis (all P less than .001). Patients with ankylosis had significantly longer duration of disease (P less than .001) and physical examinations showed more limited motion and deformity (both P less than .001). More patients with ankylosis had subcutaneous nodules (P less than .05). Functional testing with grip strength and the button test revealed poorer performance in patients with ankylosis (both P less than .001). Questionnaires revealed patients with ankylosis had more difficulty with activities of daily living (P less than .001) and had more limited activity (P less than .01); physicians estimated more limited functional capacity (P less than .001). Thus, radiographic bony ankylosis was a relatively common feature of rheumatoid arthritis, and a marker of patients whose disease was clinically, radiographically, and functionally more severe.
Topics: Age Factors; Ankylosis; Arthritis, Rheumatoid; Female; Humans; Male; Middle Aged; Radiography; Sex Factors; Time Factors
PubMed: 3583649
DOI: No ID Found -
Acta Orthopaedica Et Traumatologica... 2015A knee fusion is associated with considerable restrictions, including the inability to sit properly, use public transportation, and climb stairs. The purpose of this...
OBJECTIVE
A knee fusion is associated with considerable restrictions, including the inability to sit properly, use public transportation, and climb stairs. The purpose of this study is to report and discuss our cases of spontaneous ankylosed knees which were taken down and underwent total knee arthroplasty (TKA).
METHODS
Six patients who experienced spontaneous ankylosis of the knee undergoing conversion to TKA between 2003-2012 were enrolled retrospectively in this study. The etiology was childhood pyogenic arthritis in 2 patients, intraarticular fractures in 2, gunshot in 1, and juvenile rheumatoid arthritis in 1. The clinical data were recorded with the use of the Hospital for Special Surgery (HSS) knee rating system, Western Ontario and McMaster Questionnaire (WOMAC), and Visual Analog Scale (VAS), preoperatively and postoperatively at final follow-up.
RESULTS
The average follow-up time was 86 months (range: 22-126 months). At the final follow-up, the average range of active flexion was 85° (range: 75-95°). Postoperative average HSS knee rating system was improved from 19.5 (range: 18-22) to 57.49 (range: 46-80), WOMAC was improved from 39.75 (range: 36.4-43) to 62.41 (range: 50.8-74.5). VAS was improved from 9.5 (range: 7-9) to 2.8 (range: 2-4). A pyogenic infection developed in 2 patients; 1 was managed by debridement, and 1 was managed by arthrodesis 2 years later.
CONCLUSION
The ability to walk and sit in a normal fashion is of great importance for patients. With good preoperative planning and careful handling, gratifying results are possible with TKA.
Topics: Adult; Ankylosis; Arthritis, Infectious; Arthrodesis; Arthroplasty, Replacement, Knee; Debridement; Female; Humans; Knee Joint; Male; Middle Aged; Postoperative Complications; Range of Motion, Articular; Retrospective Studies; Tomography, X-Ray Computed; Walking; Young Adult
PubMed: 26422345
DOI: 10.3944/AOTT.2015.14.0304 -
International Journal of Paleopathology Mar 2020To better understand the pathogenesis of DISH, identifying early or pre-DISH lesions in the spine and investigating the relationship between spinal and extra-spinal...
OBJECTIVE
To better understand the pathogenesis of DISH, identifying early or pre-DISH lesions in the spine and investigating the relationship between spinal and extra-spinal manifestations of DISH.
MATERIAL
44 skeletonized individuals with DISH from the WM Bass Donated Skeletal Collection.
METHODS
For each vertebra, location, extension, point of origin and appearance of vertebral outgrowths were recorded. The size of the enthesophytes at the olecranon process, patella and calcaneal tuberosity was measured with digital callipers.
RESULTS
At either end of the DISH-ankylosed segment, isolated vertical outgrowths arising from the central third of the anterior aspect of the vertebral body can usually be observed. These bone outgrowths show a well-organized external cortical layer, an internal structure of trabecular bone and usually are unaccompanied by or show minimal associated endplate degeneration. Analysis of the relationship between spinal and extra-spinal manifestations (ESM) suggests great inter-individual variability. No correlation between any ESM and the stage of spinal DISH was found.
CONCLUSIONS
Small isolated outgrowths represent the earliest stages of the spinal manifestations of DISH. The use of ESM as an indicator of DISH should be undertaken with great caution until the relationship between these two features is understood.
SIGNIFICANCE
Improved accuracy of paleopathological diagnostic criteria of DISH.
LIMITATIONS
Small sample comprised of only individuals with DISH. FUTURE RESEARCH: micro-CT analysis to investigate the internal structure of the spinal lesions. Analysis of extra-spinal enthesophytes in individuals with and without DISH to understand their pathogenesis and association with the spinal lesions in individuals with DISH.
Topics: Aged; Aged, 80 and over; Ankylosis; Female; Humans; Hyperostosis, Diffuse Idiopathic Skeletal; Male; Middle Aged
PubMed: 31951851
DOI: 10.1016/j.ijpp.2019.12.004 -
Journal of Stomatology, Oral and... Oct 2023Costochondral graft has been a popular reconstruction choice in the past for temporomandibular joint ankylosis in young individuals. However, accounts of growth...
Costochondral graft has been a popular reconstruction choice in the past for temporomandibular joint ankylosis in young individuals. However, accounts of growth hampering complications have also been observed. Our systematic review aims to compile all existing evidence to determine the occurrence of these unfavourable clinical outcomes as well as factors affecting them to provide a better judgement on further use of these grafts. A systematic review was conducted following PRISMA guidelines where databases like PubMed, Web of science and Google Scholar were searched for the purpose of data extraction. Observational studies performed on patients younger than 18 years of age with a minimum follow-up of one year were selected. Incidence of long term complications like reankylosis, abnormal graft growth, facial asymmetry and others were considered as outcome variables. Eight articles with a total of 95 patients were selected where complications like reankylosis (6.32%), graft overgrowth (13.70%), insufficient graft growth (22.11%), no graft growth (3.20%) and facial asymmetry (20%) were reported. Other complications like mandibular deviation (3.20%), retrognathia (1.05%) and prognathic mandible (3.20%) were also observed. Our review concludes that the occurrence of these complications was noteworthy. Thus use of costochondral graft for reconstruction in temporomandibular ankylosis in young patients holds significant risk in development of growth abnormalities. However, modifications in surgical procedure such as use of appropriate graft cartilage thickness and the presence and type of interpositional material can favourably affect the frequency and type of growth abnormality.
Topics: Humans; Facial Asymmetry; Temporomandibular Joint Disorders; Ankylosis; Temporomandibular Joint
PubMed: 36914003
DOI: 10.1016/j.jormas.2023.101437 -
Foot and Ankle Clinics Jun 2017In patients with a stiff ankle replacement, appropriate resection of scarred capsular structures, hypertrophic bone debridement, and careful release of tendons should be... (Review)
Review
In patients with a stiff ankle replacement, appropriate resection of scarred capsular structures, hypertrophic bone debridement, and careful release of tendons should be performed to achieve good outcomes. Appropriately sized and correctly implanted components are required to restore ankle function to as normal as possible. Although not proven, the better a total ankle replacement is balanced, the less likely scar and heterotopic bone formation will occur. In patients with a stiff and painful ankle replacement, a preoperative diagnostic workup is mandatory to understand the underlying pathologic process and plan appropriate treatment. All underlying causes should be addressed.
Topics: Ankle; Ankle Joint; Ankylosis; Arthroplasty, Replacement, Ankle; Debridement; Diagnosis, Differential; Humans; Postoperative Complications; Preoperative Period
PubMed: 28502356
DOI: 10.1016/j.fcl.2017.01.012 -
The Journal of Rheumatology Oct 2017
Topics: Ankylosis; Burns; Female; Hand Joints; Humans; Middle Aged; Radiography
PubMed: 28966169
DOI: 10.3899/jrheum.161388 -
The Journal of Bone and Joint Surgery.... Nov 1985Ten patients with 13 ankylosed elbows after burns are described. Six elbows, fixed in nearly full extension, had almost total functional disability; the other seven had...
Ten patients with 13 ankylosed elbows after burns are described. Six elbows, fixed in nearly full extension, had almost total functional disability; the other seven had varying amounts of deformity. In five of the 13 elbows there was a continuous bony mass with loss of the joint space; these were treated by a modified excision arthroplasty which restored good movement and useful function, though there was some lateral laxity. Six elbows had a posterior bony block; this was excised, which restored a useful arc of movement. The literature on bony ankylosis after burns is reviewed and the management of these cases in a developing country is described.
Topics: Adolescent; Adult; Ankylosis; Arthroplasty; Burns; Elbow Joint; Female; Humans; Male; Radiography
PubMed: 4055874
DOI: 10.1302/0301-620X.67B5.4055874 -
The Journal of the American Academy of... Dec 2011Altered biomechanics secondary to hip ankylosis often result in degeneration of the lumbar spine, ipsilateral knee, and contralateral hip and knee. Symptoms in these... (Review)
Review
Altered biomechanics secondary to hip ankylosis often result in degeneration of the lumbar spine, ipsilateral knee, and contralateral hip and knee. Symptoms in these joints may be reduced with conversion total hip arthroplasty (THA) of the ankylosed hip. THA in the ankylosed hip is a technically challenging procedure, and the overall clinical outcome is generally less satisfactory than routine THA performed for osteoarthritis and other etiologies. Functional integrity of the hip abductor muscles is the most important predictor of walking ability following conversion THA. Many patients experience persistent limp, and it can take up to 2 years to fully assess final functional outcome. Risk factors cited for increased risk of failed THA include prior surgical ankylosis and age <50 years at the time of conversion THA.
Topics: Ankylosis; Arthroplasty, Replacement, Hip; Femur Neck; Gait; Hip Joint; Humans; Osteotomy; Reoperation; Treatment Outcome
PubMed: 22134206
DOI: 10.5435/00124635-201112000-00004