Interpositional arthroplasty using cartilage allografts for treating temporomandibular joint arthrosis: A 3- and 5-year retrospective clinical follow-up study

Van Son Nguyen; Thomas Kofod; Even Nisja; Mandana Hosseini; Nils Worsaae

doi:10.1016/j.oooo.2024.02.002

Interpositional arthroplasty using cartilage allografts for treating temporomandibular joint arthrosis: A 3- and 5-year retrospective clinical follow-up study

Oral Surg Oral Med Oral Pathol Oral Radiol. 2024 Feb 12:S2212-4403(24)00061-0. doi: 10.1016/j.oooo.2024.02.002. Online ahead of print.

Authors

Van Son Nguyen¹, Thomas Kofod², Even Nisja², Mandana Hosseini³, Nils Worsaae²

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Electronic address: van.son.nguyen@regionh.dk.
² Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
³ Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark.

PMID: 38570274
DOI: 10.1016/j.oooo.2024.02.002

Abstract

Objective: To evaluate the effect of arthroplasty using interpositional cartilage allografts in patients with temporomandibular joint (TMJ) arthrosis.

Study design: This retrospective study included patients treated consecutively between 2007 and 2013 using discectomy and interpositional grafting with lyophilized costal cartilage allograft (Tutoplast) sheets. TMJ pain based on the visual analogue scale (VAS), maximal interincisal opening (MIO), joint tenderness to palpation, crepitus from the affected joint, and postoperative complications were assessed.

Results: Arthroplasty was performed on 37 joints among 34 patients (28 women; mean age: 54 years); 24 joints underwent simultaneous condyle shaving. At final follow-up (3 [n = 37] or 5 [n = 21] years), we observed reduced mean VAS (from 7.6 to 0.9; P < .001) increased mean MIO (from 32.5 to 41.1 mm; P < .001), number of joints with capsule tenderness (from 30 to 3; P < .001), and percentage of joints with crepitus (from 97% to 75%; P = .008). One joint required reoperation because of interposed cartilage fragmentation. No permanent facial nerve injury or malocclusion occurred after treatment.

Conclusions: Interpositional arthroplasty is a relatively simple, moderately invasive, and effective surgical treatment for TMJ arthrosis with few complications. However, long-term outcomes of this treatment, specifically beyond 3-5 years postoperatively, remain unknown.