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Journal of Stomatology, Oral and... Jun 2021Temporomandibular Joint (TMJ) ankylosis as a sequelae following hemarthrosis from trauma, middle ear infection and progressive debilitating arthritis of various...
Temporomandibular joint alloplastic reconstruction of post-traumatic joint degeneration with Sawhney Type I ankylosis using 3D-custom GD-condylar cap prosthesis to restore condylar form and function.
Temporomandibular Joint (TMJ) ankylosis as a sequelae following hemarthrosis from trauma, middle ear infection and progressive debilitating arthritis of various etiologies has been well understood, but challenges always arise in terms of choosing least morbid procedure with maximum functional outcome. Total joint replacement (TJR) is the common final stage correction mandating extensive surgical exposure with good technical expertise with its limitations of risk of failure and complications. A case of post-traumatic TMJ degeneration with ankylosis reconstructed using a customised GD-condylar cap prosthesis is described. The patient had an uneventful post-operative period with an acceptable functional outcome. CONCLUSION: The condylar cap prosthesis is a bio-compatible and biomechanically designed in such a way that it can be used for indicated cases by performing minimally invasive surgical technique to achieve an optimal functional and aesthetic outcome.
Topics: Ankylosis; Arthroplasty, Replacement; Humans; Joint Prosthesis; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 32977036
DOI: 10.1016/j.jormas.2020.09.002 -
Journal of Orthopaedic Science :... 1999Shoulder stiffness occurs as a result of (1) contractures of the intraarticular capsule or muscle-tendon units or (2) adhesions within the extraarticular humeroscapular... (Review)
Review
Shoulder stiffness occurs as a result of (1) contractures of the intraarticular capsule or muscle-tendon units or (2) adhesions within the extraarticular humeroscapular or scapulothoracic motion interface. These contractures or adhesions may occur independently or in combination. A thorough history and physical examination usually reveal the diagnosis (idiopathic frozen shoulder or posttraumatic stiff shoulder) and the anatomical locations of fibrosis that is causing stiffness, and identifies other treatable conditions associated with shoulder stiffness (such as diabetes). A gentle home program of passive stretching is effective in most patients. When the home program is not effective, a manipulation or surgical release may be indicated. If manipulation is not effective, capsular contractures are best released arthroscopically as this allows circumferential release without damaging the rotator cuff and thus allows rehabilitation without the need to protect the rotator cuff. The humeroscapular motion interface adhesions can be released either open or arthroscopically, but we believe that an open release combined with an arthroscopic capsular release is quicker and does not interfere with rehabilitation. When necessary, operative management coupled with an aggressive rehabilitation program can provide significant relief of pain and restoration of shoulder motion. Approximately 90% of patients can expect a good result with this treatment algorithm.
Topics: Algorithms; Ankylosis; Arthroscopy; Exercise Therapy; Humans; Manipulation, Orthopedic; Range of Motion, Articular; Shoulder
PubMed: 10664431
DOI: 10.1007/s007760050131 -
Australian Dental Journal Sep 2013Temporomandibular joint ankylosis is not common in our community but can occur as a result of severe facial trauma or significant connective tissue disorders such as...
Temporomandibular joint ankylosis is not common in our community but can occur as a result of severe facial trauma or significant connective tissue disorders such as rheumatoid arthritis, osteoarthritis and psoriatic arthritis, and unfortunately as a result of iatrogenic causes. Ankylosis surgery is aimed at gap arthroplasty and mobilization of the joints. However, the removal of the bony ankylosis and the production of a gap between the ramus of the mandible and the base of the skull is often difficult because of the size of the ankylosis and the anatomy on the inner aspect of the mandible. As a result of this, the author has found that surgical navigation has been useful with the removal of the ankylosis, both on the medial side of the mandible and the cranial base. Once the ankylosis has been freed and the mandible mobilized, the gap arthroplasty needs to be maintained or the release of the ankylosis will fail and the joints will re-ankylose. It is important to maintain the space produced by the arthroplasty but this is difficult when autogenous materials such as temporalis muscle, dermis fat and other like materials are used. The gap ultimately closes under the influence of the masseter and medial pterygoid muscles and the ankylosis may return. This case report presents three representative patients in whom ankylosis has been released and the gap reconstructed with a total alloplastic joint replacement. All patients have had their ankylosis removed with the aid of a navigation system and all patients have been reconstructed with bilateral Biomet prosthesis. One patient has had their implant selected using virtual planning and the production of templates to help with placement of the stock implant.
Topics: Adipose Tissue; Adolescent; Adult; Ankylosis; Arthroplasty; Arthroplasty, Replacement; Female; Humans; Male; Mandible; Masseter Muscle; Middle Aged; Recurrence; Surgery, Computer-Assisted; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 23981219
DOI: 10.1111/adj.12086 -
Revue Belge de Medecine Dentaire 1987
Review
Topics: Ankylosis; Cartilage; Child; Humans; Ribs; Temporomandibular Joint Disorders
PubMed: 3332395
DOI: No ID Found -
Arthritis and Rheumatism Nov 1988To determine its similarity to human spondylarthropathies, we studied murine progressive ankylosis, a spontaneously occurring disorder of joints in mice. Clinically,...
To determine its similarity to human spondylarthropathies, we studied murine progressive ankylosis, a spontaneously occurring disorder of joints in mice. Clinically, peripheral joints were inflamed initially, then became ankylosed in a predictable sequence from distal to proximal. Forefeet were involved before hindfeet. Axial joint involvement produced severe spinal ankylosis. Extraarticular manifestations included balanitis and crusting skin lesions. Radiographically, bony erosions and calcification of articular and periarticular tissues were extensive, and vertebral syndesmophytes produced a "bamboo" spine. We conclude that progressive ankylosis is a systemic disease with many clinical and radiographic similarities to human spondylarthropathies, and it may represent a useful animal model for the study of the human diseases.
Topics: Animals; Ankylosis; Arthrography; Blood Chemical Analysis; Disease Models, Animal; Female; Foot; Male; Mice; Mice, Inbred Strains; Rheumatoid Factor; Rodent Diseases; Spinal Diseases
PubMed: 3190783
DOI: 10.1002/art.1780311108 -
International Journal of Oral and... Dec 2009This study evaluates the authors' technique using the intraoral approach for the management of temporomandibular joint (TMJ) ankylosis. The technique was used on 16 TMJs...
This study evaluates the authors' technique using the intraoral approach for the management of temporomandibular joint (TMJ) ankylosis. The technique was used on 16 TMJs in 14 patients with a mean age of 28.5 years; their average postoperative mouth-opening was 33.7 mm. All the patients had Sawhney's type IV TMJ ankylosis except a child with type I. One patient had recurrent ankylosis and was managed using the same intraoral approach again. Average follow-up was 56 months. The protocol consists of interpositional arthroplasty via an intraoral approach and aggressive mouth-opening exercises. An intraoral incision is made over the buccal shelf and the soft tissue of the mandibular ramus reflected. Osteotomy is carried out at the coronoid process and adequate osteotomy is accomplished at the level of the condylar neck. Adequate gap osteotomy at the ankylosed condyle is performed and followed by placement of the interpositional material, such as rib cartilage, masseter, buccal fat pad and costochondral graft. The wound is then closed meticulously. The advantages of this intraoral approach are excellent cosmetic appearance with no facial scar, lower risk of injury to the facial nerve or auriculotemporal nerve and no salivary fistula formation.
Topics: Adipose Tissue; Adolescent; Adult; Ankylosis; Arthroplasty; Cartilage; Child; Exercise Therapy; Female; Follow-Up Studies; Humans; Male; Mandible; Mandibular Condyle; Middle Aged; Osteotomy; Range of Motion, Articular; Recurrence; Temporomandibular Joint Disorders; Young Adult
PubMed: 19733034
DOI: 10.1016/j.ijom.2009.07.016 -
Journal of Oral and Maxillofacial... Jan 2014This article presents a novel method of navigation-guided lateral gap arthroplasty (LGA) in the treatment of temporomandibular joint ankylosis (TMJA). (Comparative Study)
Comparative Study
PURPOSE
This article presents a novel method of navigation-guided lateral gap arthroplasty (LGA) in the treatment of temporomandibular joint ankylosis (TMJA).
MATERIALS AND METHODS
Six patients with unilateral TMJA from 2007 through 2011 were included in this study. Presurgical planning was performed to determine the amount and extent of ankylosed bone to be resected using the simulation platform. Minimum follow-up was 6 months. Patients were monitored for complications and signs of recurrence. Maximum mouth opening (MO) was measured and compared intra- and postoperatively.
RESULTS
Preoperative planning was performed at the STN or Accu-Navi workstation. The amount and extent of ankylosed bone to be resected was determined. All 6 LGAs were completed successfully using real-time instrument- and pointer-based navigation. Measurements performed intraoperatively showed that the mean for maximum MO was about 35 to 40 mm and remained the same postoperatively. Follow-up evaluation showed remarkable improvement in function and esthetics, with no signs of recurrence.
CONCLUSION
Navigation-guided LGA can be regarded a viable option for performing this delicate and complicated surgical procedure.
Topics: Adolescent; Adult; Anatomic Landmarks; Ankylosis; Arthroplasty; Computer Simulation; Female; Follow-Up Studies; Humans; Intraoperative Care; Male; Mandibular Condyle; Mandibular Fractures; Models, Anatomic; Patient Care Planning; Physical Therapy Modalities; Postoperative Complications; Range of Motion, Articular; Recurrence; Surgery, Computer-Assisted; Temporomandibular Joint Disorders; Tomography, X-Ray Computed; Treatment Outcome; User-Computer Interface; Young Adult
PubMed: 24095006
DOI: 10.1016/j.joms.2013.07.039 -
Clinical Orthopaedics and Related... Nov 2008
Topics: Ankylosis; Arthroplasty; History, 19th Century; History, 20th Century; Humans; United States
PubMed: 18758879
DOI: 10.1007/s11999-008-0455-5 -
Clinics in Orthopedic Surgery Dec 2014Myositis ossificans traumatica is an unusual complication following a muscle contusion injury. A significantly large myositic mass causing ankylosis of the elbow is even...
Myositis ossificans traumatica is an unusual complication following a muscle contusion injury. A significantly large myositic mass causing ankylosis of the elbow is even rarer. We report a 13-year-old boy who presented with a 14-month history of a fixed elbow with no movement and a palpable bony mass in the anterior aspect of the elbow. He had sustained significant trauma to the affected limb 1 month prior to onset of symptoms, which was managed by native massage and bandaging for 4 weeks. The clinicoradiological diagnosis was suggestive of myositis ossificans, and the myositic mass was completely excised. Histopathology revealed lamellar bone. The 2-year follow-up showed full function of the affected limb and no signs of recurrence. We report this case of clinical interest due to the unusually large myositic mass.
Topics: Adolescent; Ankylosis; Contusions; Elbow Joint; Humans; Male; Myositis Ossificans; Radiography
PubMed: 25436075
DOI: 10.4055/cios.2014.6.4.480 -
Atlas of the Oral and Maxillofacial... Sep 2020Temporomandibular joint ankyloses are a fusion of the mandibular condyle to the base of skull. Surgical advances have stemmed from innovation in computer planning,... (Review)
Review
Temporomandibular joint ankyloses are a fusion of the mandibular condyle to the base of skull. Surgical advances have stemmed from innovation in computer planning, guidance, and intraoperative navigation, allowing surgeons to restore form and function with greater precision, predictability, and safety. Preoperative computer virtual surgical planning used the computed tomography scan data to render a 3-dimensional image that can be used for surgical simulations and fabrication of intraoperative aids. Temporomandibular joint reconstruction should be considered as a predictable option in the management of temporomandibular joint ankylosis. Intraoperative navigation allows for continuous real-time 3-dimensional positioning of instruments.
Topics: Ankylosis; Humans; Mandibular Condyle; Surgery, Computer-Assisted; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 32741508
DOI: 10.1016/j.cxom.2020.05.005