Saturday, April 22, 2017

Detailed Explanation of My Upcomng TJR

Detailed Explanation-What is TJR (total joint replacement) and why I am a candidate for it?


Here is some background information about what is wrong with my jaw:

1) Idiopathic Condylar Resorption-  a temporomandibular joint disorder in which one or both of the mandibular condyles are broken down in a bone resorption process. This disorder is nine times more likely to be present in females than males, and is more common among teenagers.  It causes open bites, receding chin, clicking & popping when opening/closing the jaw, pain, and limited mobility.
                                                                These are not my teeth-but my bite is similar

2) Osteoarthritis-a unilateral, degenerative disease of the jaw joint.  It is characterized by the breakdown of the articular cartilage, architectural changes in the bone, and tissue damage. 
3)Ankylosis- abnormal stiffening and immobility of a joint due to fusion of the bones.

                                                          These are not my CT scan's but they show ankylosis

4) In layman’s terms, the bones in my jaw are disintegrating and causing pain, my open bite, and limited opening.

May 8th
1) I will be admitted to the hospital to have a minor procedure performed by an Interventional Neuroradiolist. 
2)The minor surgical procedure is called an Embolization.
3) The doctor will make a small incision on both legs (near my groin) and snake the stent through my body to my jaw.  While most stents are used to clear blocked arteries, my stents are being used to block blood flow so my surgeon can see well during the TJR. 


3) I believe this is a relatively painless procedure.  I will be under anesthesia, but for a limited amount of time. 

4)Much to my displeasure, I will be staying over night in the hospital.  I guess it is for the best since my main surgery is the next day.

May 9th-Bilateral Total Joint Replacement (TJR)

1)   This surgery will last between 8-10 hours.
2)      The doctor will make two incisions.  The first will run behind my hairline down the facial side of my ear ending at jaw line and the second will be in the fold of my neck below my jaw line.  They might need to shave some of my hair. 

3)   The doctor will then remove a section of my jaw (the condyle and mandibular fossa).  It’s the ball and socket that controls the opening and closing of my jaw. 
4)   The doctor will then replace the joint with my titanium prosthesis. I am one of five people the FDA has approved for the implants this year.  Most implants are made out of nickel, but I am allergic so I was put on an extensive waiting list for the titanium.  I thought I would be waiting at least 5 years to get FDA approval, instead it took me 6 months.  I have no idea how my doctor did it, but he did!


5)   He will also perform orthognathic surgery to pull my jaw into place and correct my bite.  Hopefully he can do this without cutting my jaw in several other places (fingers crossed).
6)   If all goes well, I will not be wired shut. Though I will have metal guides/bars on my teeth which will look similar to the picture below. I will have rubber bands to keep my jaw in place.  The bar and rubber bands will be worn for 4-6 weeks.

7)   I do not need braces again. Once again, this is not 100%, but it doesn't look like I will need them for a 3rd time.
8)   I will be in the hospital for 4-7 days. 


What I am hoping to gain from this surgery:
1)   Better jaw function and opening.
2)   Even though this surgery is not used to take pain away, I am hoping that it will.
3)   I will be able to eat again.
4)   I hope that the muscular issues I have will eventually be healed.
5) It would be nice to go through an entire day without thinking of my jaw,



Unfortunately, there are many risks to this surgery.  A person’s face is a sensitive area because the ear canals and sinus cavities are located there.  In addition, there are glands that give some people problems. I know from previous surgeries that I can have temporary paralysis in my facial muscles.  I will get into this in more detail with the next blog post!


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