Management of recurrent heterotopic ossification around total alloplastic temporomandibular joint replacement

Abstract

Temporomandibular joint (TMJ) replacement is the gold standard for reconstruction of the ankylosed joint, as it provides the facility for early function and a suitably large gap, both aimed at the prevention of recurrence. The recurrence of heterotopic ossification is traditionally managed by resection, a temporary spacer, and remake of the prosthesis, with placement at a second procedure, which adds to costs and morbidity. Atraumatic removal of the prosthesis, resection of the heterotopic tissue, replacement of the prosthesis into its previous position, and the packing of fat around the articulation represents a technique that both minimizes morbidity and reduces costs. This technique has been utilized in three cases, with early improvement in mobility, function, and pain. It is still too early to determine whether the outcomes obtained will be maintained in the long-term.

Keywords: TMJ; alloplastic TMJ replacement; ankylosis; heterotopic bone.