Temporomandibular joint ankylosis (the temporomandibular joint, or TMJ, is the joint that hinges your jaw) is a serious, life-threatening condition that requires surgery. It can be caused by injury, infection, and autoimmune disorders such as rheumatoid arthritis, and is sometimes a birth defect. A condyle is a projecting bone process, and a condylectomy is the surgical removal of the condyle. TMJ condylectomy is necessary in many cases of TMJ intra-articular ankylosis, which can interfere with breathing and eating in a way that can stunt normal physical and mental growth. The procedure usually precedes an arthroplasty, or synthetic joint replacement.
Ankylosis is an intense stiffness in a joint that makes it almost impossible to move. To prepare the jaw for replacement of the TMJ (arthroscopy), the oversized or deformed condyle must be removed. This procedure is usually paired with a procedure that modifies the other bone part that articulates with the condyle, the coronoid. A synthetic joint can then be placed on top of these bones. Frequently, however, the bone forms a callus where the condyle or coronoid process was removed, or the bone grows back and the ankylosis returns. This can be especially problematic when the condyle grows under a replacement joint part.
Condylectomy With Added Implants
A more successful form of condylectomy procedure includes the addition of either a muscle flap, a synthetic pad or auricular cartilage to keep the condyle from growing back and causing the ankylosis to return. The most successful procedure in a 1996 study in Bangladesh published in the Bangladesh Medical Resource Council Bulletin was the condylectomy combined with the addition of a temporalis muscle flap (the muscle that connects your lower jawbone to your skull and helps you chew) over the site of the condyle removal. Patients in the study that had this type of condylectomy had the least amount of pain or problems following their subsequent joint replacement.