WellSpan Home

Open-Joint Arthroplasty for Temporomandibular Disorders

Surgery Overview

Open-joint arthroplasty is surgery to repair, reposition, replace, or remove parts in a joint. When used to treat temporomandibular disorder (TMD), this usually involves the articular disc that cushions the jaw joint.

During open-joint arthroplasty of the jaw, an incision is made in the skin to expose the jaw joint. The surgeon may repair, reposition, or replace the disc with your own tissue or an artificial disc. Scar tissue or bony growths in the jaw joint can also be removed.

Open-joint arthroplasty is done under general anesthesia. You can normally expect to go home the same day.

When jaw joint movement cannot be regained because the disc has changed too much or the joint has broken down, the surgeon may need to remove the disc (discectomy) and replace it with an artificial disc.

What To Expect

After surgery, medicines are prescribed to relieve pain and reduce swelling.

You can start physical therapy within 48 hours to maintain movement and prevent scar tissue from forming.

You may be given a mouthpiece (splint) to wear while rehabilitating your jaw.

Why It Is Done

Open-joint arthroplasty is used when:

  • There are bony growths within the jaw joint. Such growths are hard to reach with arthroscopic methods.
  • Complications from a previous surgery occur, such as the failure of an artificial joint replacement.
  • The joint is fused together by bony growth (ankylosis).
  • The joint is not accessible with arthroscopic surgery.

How Well It Works

Disc repositioning surgery can relieve pain and improve jaw function. This surgery has good results 85% to 90% of the time.footnote 1

Risks

Possible complications include:

  • Loss of jaw movement. Everyone has some decrease in jaw mobility after surgery, because the jaw heals with scar tissue, which is harder and tighter than normal tissue. But jaw exercises will help jaw movement.
  • Adverse reaction to the materials in an artificial disc. The risk of tissue rejection is higher if artificial materials, rather than your own tissue, are used.

What To Think About

When possible, a nonsurgical approach is preferred over surgery, because:

  • It is cheaper, safer, and noninvasive.
  • It can be stopped or reversed.
  • It involves less risk of permanent damage.

Current practice trends are to avoid altering disc position or structure. After disc replacement, an adverse reaction to an artificial disc is possible.

Repeat surgery is less likely to produce positive results.

Surgeries done using open-joint arthroplasty require more recovery time than do arthroscopic surgeries.

If your doctor recommends surgery, experts agree that it is best to get a second opinion.

References

Citations

  1. Tucker MR, et al. (2014). Management of temporomandibular disorders. In JR Hupp et al., eds., Contemporary Oral and Maxillofacial Surgery, 6th ed., pp. 627-647. St. Louis: Mosby.

Credits

ByHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
Elizabeth T. Russo, MD - Internal Medicine
Martin J. Gabica, MD - Family Medicine

Current as ofMarch 28, 2018


Are you sure you would like to cancel?

All information will be lost.

Yes No ×

About the provider search

This search will provide you with WellSpan Medical Group and Northern Lancaster County (Ephrata) Medical Group primary care physicians and specialists. If we don’t have a WellSpan Medical Group physician to meet your criteria, the search will expand to include community physicians who partner with WellSpan Medical Group physicians through the WellSpan Provider Network or provide care to patients on the Medical Staffs of WellSpan’s Hospitals.

×

Schedule Your Next Appointment Online with MyWellSpan

Use your MyWellSpan patient portal any time to view available appointments, and pick the date and time that best suits your schedule.

Go to MyWellSpan

New to this practice?

If you don't have a WellSpan primary care provider and would like to schedule a new patient appointment with a provider who is accepting patients, just log into your MyWellSpan account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to see the offices that are accepting new patients in relation to your zip code. If you are not enrolled in MyWellSpan, go to https://my.wellspan.org, call 1-866-638-1842 or speak with a member of the staff at a participating facility to sign up. New patient scheduling not available at all practices/programs.

Already a patient at this practice?

If you already have a relationship with a WellSpan practice, simply log into your account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to schedule an appointment with any provider or practice that already counts you as a patient. Online scheduling varies by practice/program.

×