Re: Has anybody had Arthroplasty with pins? - to Felshie

[Guest guest]

Hi Felshie,

The biggest consideration for me to go through joint surgery was

function. I've had bad joints since childhood from being

congenitally abnormal and then having multiple dislocations starting

when I was about 8. That led to my lower jaw not growing and

developing properly so I ended up with a huge open and overbite.

When I started the orthognathic process, I was having surprisingly

little joint pain, nothing that an occasional Motrin didn't take

care of, even though x-rays showed a lot of arthritic changes.

Initially we decided to just correct my bite. My surgeon didn't want

to touch my joints since I was relatively asymptomatic. To protect

the joints, he did the orthognathic surgery in two stages. First he

slowly advanced my lower jaw 17 mm using distraction osteogenesis.

Two months later, he raised my upper jaw 5 mm.

Most people have some, if not complete, improvement of their TMJ

symptoms but mine got worse. On the left, the condyle disintegrated

and the right joint fused (ankylosed). I could only open 6 mm six

months post-op and my bite was starting to open up again. My surgeon

did arthrocentesis (flushed out the joints and injected steroids to

try to free up the joints) but it didn't work. At that point, my

orthognathic surgeon referred me to a TMJ specialist.

I had my first joint surgery in May 2003. My TMJ surgeon wanted to

be as conservative as possible so he did only the arthroplasties. I

did well for about six months, then I started having more pain and

decreased opening again. Next he tried to reconstruct the condyles

using distraction osteogenesis again. He really wanted to avoid

artificial joints because he felt I was too young at 36. The

distraction was painful but worked great. For a year, my new joints

were good and my bite was normal again. Then, the arthritis flared

up again and the new condyles started to disintegrate again. That's

when we went to our last resort - bilateral total joint

replacements. My surgeon had my joints designed so that they would

correct for my open bite which worked great. My bite is now perfect.

I'm now 4 1/2 months post-op from the joint replacements so I'm

pretty much recovered. I'm doing better than I was before but with

the artificial joints, I'll never be able to eat things like steak

or raw veggies.

I guess my surgeries did help in the long run. Without the

surgeries, my joints were still deteriorating - I just didn't have a

lot of symptoms. My back teeth were also wearing down from being the

only teeth to touch. My molars are worn down to nubs and will

probably need crowns. Maybe if I had had my orthognathic surgery 10-

15 years ago (although it wasn't an option then), I wouldn't have

needed all the joint surgeries.

You just have to weigh how bad your joint problems are now versus

the possible risks. Open joint surgery can lead to more invasive

joint procedures in the future. Then again, I have a friend who had

TMJ arthroplasty over 10 years ago and has done great since then.

Let me know what you decide.

>

> Hi , thank you so much for responding. I haven't

> really talked to anybody who has had open joint

> surgery. My oral surgeon says that they will remove

> the disc completely if it is too damaged...which, of

> course, concerns me because I worry that that will

> eventually lead me down the road to joint replacement.

> Is joint surgery something you would recommend? Did it

> help you at all in the long run? I too will have to

> have an orthognathic surgery to correct my open bite.

> Did they do that to you before doing joint

> replacements and if so, did that pose a problem?

> Thanks,

> Felshie

[Guest guest]

Thanks for the info- I've been really weighing the

decisions carefully and talking to someone with an

open bite who has also had joint trouble is helpful. I

really haven't met anybody with a bad open bite AND

joint displacement in person- so I do appreciate the

chance to get an insider's viewpoint.

My joints are painful, and they don't function so

well. I can open and close pretty well at this point

but my open bite is so bad and the muscles are so

tense and over extended and my joint pain is so bad

that I can't really handle much. My physical therapist

and surgeons are concerned that the displacement and

tightness within my joints will pull the post-op

orthognathic placement of my jaws awry- which would be

bad- and that I will be at risk for further joint

deteriation as I age if my disks aren't fixed now (I'm

24). SO- I'm leaning more and more towards having it

done. That means definite 2 surgeries and a lot of

money (my insurance will tip in about 8500 and the

rest of all of the surgeries and ortho is up to

me)...but if I can chew, talk, sing, laugh, etc

without horrible pain that would be nice. I'd also

just like to be able to leave this behind me. From

what I'm gathering, would you say that if the discs

are still viable and the condyle is pretty stable- the

tmj surgery can result in long-term well-being?

Thank you so much.

Felshie

--- minirascal2002 <no_reply > wrote:

> Hi Felshie,

>

> The biggest consideration for me to go through joint

> surgery was

> function. I've had bad joints since childhood from

> being

> congenitally abnormal and then having multiple

> dislocations starting

> when I was about 8. That led to my lower jaw not

> growing and

> developing properly so I ended up with a huge open

> and overbite.

> When I started the orthognathic process, I was

> having surprisingly

> little joint pain, nothing that an occasional Motrin

> didn't take

> care of, even though x-rays showed a lot of

> arthritic changes.

> Initially we decided to just correct my bite. My

> surgeon didn't want

> to touch my joints since I was relatively

> asymptomatic. To protect

> the joints, he did the orthognathic surgery in two

> stages. First he

> slowly advanced my lower jaw 17 mm using distraction

> osteogenesis.

> Two months later, he raised my upper jaw 5 mm.

>

> Most people have some, if not complete, improvement

> of their TMJ

> symptoms but mine got worse. On the left, the

> condyle disintegrated

> and the right joint fused (ankylosed). I could only

> open 6 mm six

> months post-op and my bite was starting to open up

> again. My surgeon

> did arthrocentesis (flushed out the joints and

> injected steroids to

> try to free up the joints) but it didn't work. At

> that point, my

> orthognathic surgeon referred me to a TMJ

> specialist.

>

> I had my first joint surgery in May 2003. My TMJ

> surgeon wanted to

> be as conservative as possible so he did only the

> arthroplasties. I

> did well for about six months, then I started having

> more pain and

> decreased opening again. Next he tried to

> reconstruct the condyles

> using distraction osteogenesis again. He really

> wanted to avoid

> artificial joints because he felt I was too young at

> 36. The

> distraction was painful but worked great. For a

> year, my new joints

> were good and my bite was normal again. Then, the

> arthritis flared

> up again and the new condyles started to

> disintegrate again. That's

> when we went to our last resort - bilateral total

> joint

> replacements. My surgeon had my joints designed so

> that they would

> correct for my open bite which worked great. My bite

> is now perfect.

>

> I'm now 4 1/2 months post-op from the joint

> replacements so I'm

> pretty much recovered. I'm doing better than I was

> before but with

> the artificial joints, I'll never be able to eat

> things like steak

> or raw veggies.

>

> I guess my surgeries did help in the long run.

> Without the

> surgeries, my joints were still deteriorating - I

> just didn't have a

> lot of symptoms. My back teeth were also wearing

> down from being the

> only teeth to touch. My molars are worn down to nubs

> and will

> probably need crowns. Maybe if I had had my

> orthognathic surgery 10-

> 15 years ago (although it wasn't an option then), I

> wouldn't have

> needed all the joint surgeries.

>

> You just have to weigh how bad your joint problems

> are now versus

> the possible risks. Open joint surgery can lead to

> more invasive

> joint procedures in the future. Then again, I have a

> friend who had

> TMJ arthroplasty over 10 years ago and has done

> great since then.

>

> Let me know what you decide.

>

>

>

>

> >

> > Hi , thank you so much for responding. I

> haven't

> > really talked to anybody who has had open joint

> > surgery. My oral surgeon says that they will

> remove

> > the disc completely if it is too damaged...which,

> of

> > course, concerns me because I worry that that will

> > eventually lead me down the road to joint

> replacement.

> > Is joint surgery something you would recommend?

> Did it

> > help you at all in the long run? I too will have

> to

> > have an orthognathic surgery to correct my open

> bite.

> > Did they do that to you before doing joint

> > replacements and if so, did that pose a problem?

> > Thanks,

> > Felshie

>

>

>

>

>

__________________________________

Yahoo! FareChase: Search multiple travel sites in one click.

http://farechase.yahoo.com

[Guest guest]

Hi Felshie,

TMJ surgery can result in long-term well being but like anything

else, there are no guarantees. My joint pains have gotten better but

I still have daily headaches and pains around the joints that are as

bad as ever. It's mainly muscular pain now. In the past, my surgeon

has treated me with botox which worked wonders for me. I can't take

muscle relaxants because they make me drowsy and I need to stay at

maximum alertness on my job. The botox injections eased the muscle

tension for 2-3 months at a time. My surgeon has not wanted to use

the botox on me post-op because he wants my muscles to recover and

strengthen more. My next appt with him isn't until Dec 20 but I

don't think I can hold out that long. The pain is getting to me even

with tons of tylenol and motrin. I hope that eventually my muscles

will get used to my new jaw position and relax on their own. It may

be that it's been harder on my muscles than most because the jaw

movements were so large (17 mm lower, 5 mm upper, 15 mm for the

condyles). Several people on this site have reported that their

headaches and TMJ pains went away completely with the surgery.

Everyone is different. I hope you get good relief with whatever you

decide.

> > >

> > > Hi , thank you so much for responding. I

> > haven't

> > > really talked to anybody who has had open joint

> > > surgery. My oral surgeon says that they will

> > remove

> > > the disc completely if it is too damaged...which,

> > of

> > > course, concerns me because I worry that that will

> > > eventually lead me down the road to joint

> > replacement.

> > > Is joint surgery something you would recommend?

> > Did it

> > > help you at all in the long run? I too will have

> > to

> > > have an orthognathic surgery to correct my open

> > bite.

> > > Did they do that to you before doing joint

> > > replacements and if so, did that pose a problem?

> > > Thanks,

> > > Felshie

> >

> >

> >

> >

> >

>

>

>

>

> __________________________________

> Yahoo! FareChase: Search multiple travel sites in one click.

> http://farechase.yahoo.com

>

[Guest guest]

Ok- that's good to know.

Thank you,

Felshie

--- minirascal2002 <no_reply > wrote:

> Hi Felshie,

> TMJ surgery can result in long-term well being but

> like anything

> else, there are no guarantees. My joint pains have

> gotten better but

> I still have daily headaches and pains around the

> joints that are as

> bad as ever. It's mainly muscular pain now. In the

> past, my surgeon

> has treated me with botox which worked wonders for

> me. I can't take

> muscle relaxants because they make me drowsy and I

> need to stay at

> maximum alertness on my job. The botox injections

> eased the muscle

> tension for 2-3 months at a time. My surgeon has not

> wanted to use

> the botox on me post-op because he wants my muscles

> to recover and

> strengthen more. My next appt with him isn't until

> Dec 20 but I

> don't think I can hold out that long. The pain is

> getting to me even

> with tons of tylenol and motrin. I hope that

> eventually my muscles

> will get used to my new jaw position and relax on

> their own. It may

> be that it's been harder on my muscles than most

> because the jaw

> movements were so large (17 mm lower, 5 mm upper, 15

> mm for the

> condyles). Several people on this site have reported

> that their

> headaches and TMJ pains went away completely with

> the surgery.

> Everyone is different. I hope you get good relief

> with whatever you

> decide.

>

>

>

>

>

>

> >

> > > Hi Felshie,

> > >

> > > The biggest consideration for me to go through

> joint

> > > surgery was

> > > function. I've had bad joints since childhood

> from

> > > being

> > > congenitally abnormal and then having multiple

> > > dislocations starting

> > > when I was about 8. That led to my lower jaw not

> > > growing and

> > > developing properly so I ended up with a huge

> open

> > > and overbite.

> > > When I started the orthognathic process, I was

> > > having surprisingly

> > > little joint pain, nothing that an occasional

> Motrin

> > > didn't take

> > > care of, even though x-rays showed a lot of

> > > arthritic changes.

> > > Initially we decided to just correct my bite. My

> > > surgeon didn't want

> > > to touch my joints since I was relatively

> > > asymptomatic. To protect

> > > the joints, he did the orthognathic surgery in

> two

> > > stages. First he

> > > slowly advanced my lower jaw 17 mm using

> distraction

> > > osteogenesis.

> > > Two months later, he raised my upper jaw 5 mm.

> > >

> > > Most people have some, if not complete,

> improvement

> > > of their TMJ

> > > symptoms but mine got worse. On the left, the

> > > condyle disintegrated

> > > and the right joint fused (ankylosed). I could

> only

> > > open 6 mm six

> > > months post-op and my bite was starting to open

> up

> > > again. My surgeon

> > > did arthrocentesis (flushed out the joints and

> > > injected steroids to

> > > try to free up the joints) but it didn't work.

> At

> > > that point, my

> > > orthognathic surgeon referred me to a TMJ

> > > specialist.

> > >

> > > I had my first joint surgery in May 2003. My TMJ

> > > surgeon wanted to

> > > be as conservative as possible so he did only

> the

> > > arthroplasties. I

> > > did well for about six months, then I started

> having

> > > more pain and

> > > decreased opening again. Next he tried to

> > > reconstruct the condyles

> > > using distraction osteogenesis again. He really

> > > wanted to avoid

> > > artificial joints because he felt I was too

> young at

> > > 36. The

> > > distraction was painful but worked great. For a

> > > year, my new joints

> > > were good and my bite was normal again. Then,

> the

> > > arthritis flared

> > > up again and the new condyles started to

> > > disintegrate again. That's

> > > when we went to our last resort - bilateral

> total

> > > joint

> > > replacements. My surgeon had my joints designed

> so

> > > that they would

> > > correct for my open bite which worked great. My

> bite

> > > is now perfect.

> > >

> > > I'm now 4 1/2 months post-op from the joint

> > > replacements so I'm

> > > pretty much recovered. I'm doing better than I

> was

> > > before but with

> > > the artificial joints, I'll never be able to eat

> > > things like steak

> > > or raw veggies.

> > >

> > > I guess my surgeries did help in the long run.

> > > Without the

> > > surgeries, my joints were still deteriorating -

> I

> > > just didn't have a

> > > lot of symptoms. My back teeth were also wearing

> > > down from being the

> > > only teeth to touch. My molars are worn down to

> nubs

> > > and will

> > > probably need crowns. Maybe if I had had my

> > > orthognathic surgery 10-

> > > 15 years ago (although it wasn't an option

> then), I

> > > wouldn't have

>

=== message truncated ===

__________________________________

Yahoo! FareChase: Search multiple travel sites in one click.

http://farechase.yahoo.com