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TMJ Disorder -TemporoMandibular Joint Message Board


TMJ Disorder -TemporoMandibular Joint Board Index


Hi davec,

I'm not sure what a modified meniscoplasty, "is" exactly....

I assume it means removal of the disc in some manner, because they cannot be repaired. (Dr. Stack's report) I did try to reseach this and couldn't find an explanation of the procedure. I could be on the wrong track here, if so, I apologize.
The closest I could come to an explanation was, removing the disc without disturbing or injuring the surrounding tissue, bone, etc.

I had a bilateral discectomy or menisectomy, 7 years ago. Removal of both disc. Proper follow-up care was a brief period of PT and meds.
Splint therapy was not included and even discouraged. I suffered terribly for 5 years, finally found splint therapy designed for this condition (as Dr. Stack indicates "IS" necessary) and am doing extremely well now.

Removal of deteriorated or irrepairable disc has become, in the last few years, more accepted as the appropriate step. When I had it done, it was my only option. It seems the Medical Profession has learned a great deal since then. It was rough, at the time I had this done.

The surgeries that you see many write about and are discussed as being terribly invasive and damaging include almost all that can be done for TM joint problems. The members who got into these surgeries 10-15 & 20 years ago and have continued to have surgery after surgery, have written much about these procedures and the failures. Myself included.

We were, in reality, having procedures that in theory should work, but didn't.
Some of us had terribly invasive procedures done before C-scans & MRI's were used to assess the problem or the damage we had. Some had implants that had not been fully tested and approved by the FDA.

I had 2 orthognathics (bone restructuring) for TMJ in 1988. I didn't have any deformities or even bad occlusion, but they thought creating a different "bite" would cure the problem. This was done without (MRI) or other imaging of the joints.

Once, MRI's became common within the next year or so, it was determined my disc were deteriorated beyond repair, my joint capsule was abnormal, and the first 2 procedures had been useless and caused more trauma.

I had to have bone grafts (maxilla & mandible) due to infection from these procedures.

In the early 90's they were doing autogenous grafts to replace disc. I had an open joint procedure (Arthroplasty) to replace mine with ear cartilage. They used and are still using cartilage and muscle grafts, but they know (now)these materials do not last. Statistic's say 2-5 years normally. Mine started to deteriorate after 2 years. There are reports that some have lasted longer.

In 1997, I had another Arthroplasty to remove the replacements and nothing put in. They believed this was the best option at that time. They just didn't know how to help your body and muscles adjust to being without disc. (I also have very little left of my condyles and the joint capsule has never been normal)

All total, I have had 7 surgeries because of TMJ and the only one I really should have had was, the removal of the disc.
With the proper follow-up care, I believe (now) it was the best thing for me. It just took a while to get the follow-up care I needed.
I have nerve & muscle damage & bone loss due to the earlier procedures. My TMJ treatment began in 1977 and I still wear a very small & comfortable splint at night to keep the muscles from spasming.

There are others who have had many more arthroscopic & arthroplastic procedures, than I did. They are still looking at more surgeries to try to get where I am now. Out of pain and functional.
Many people had faulty plastic or metal implants and they are, by far, having the greatest problems.
Some of the later, metal based implants are reported to be working for some people.

All of these procedures performed on the TM joints do carry risks as most surgeries do. There is always the possibilty of nerves being damaged or the unforseen happening. Find out everything you can about this procedure and be aware.

Again, if I'm on the right track at all, having the disc removed, does seem to have been improved and refined. It does seem to be the best option when there is no hope of saving the disc.

If I had to do it again, I would, with a Surgeon who knew the appropriate after-care that is absolutely required.

Let me know if this has helped or if this procedure is something totally different. I would be very interested in what it is, if not a refinement of the original Discectomies.

Cymy Sue
Thanks for your in depth reply, I am so sorry to hear that you have had long term problems with your jaw, sounds dreadful. Unfortunately I come to this forum with other problems too, not just jaw problems. I currently run a forum that deals with long-term side effects from a prescription drug called Accutane/Roaccutane which is prescribed for acne. I have had long term side effects for the last 10 years so itís kind of been a battle too.

Anyway I digress. From my understanding the surgery takes around 45 mins for each side and involves putting the discs back in their proper position, what ever that is. I am pretty sure it does not involve taking the discs out, so my discs must be in a reasonable condition I believe/hope. The study by Stack goes into great detail about the procedure and it sounds as though there was quite a high success rate if the patient is highly motivated. I have spoken to people who had the same treatment some 5-10 years ago, who have not looked back and said is was the best thing they could have ever done and they told me it will be painful but to stick with the program.

I would gladly send you a copy of the study in the mail/fax so you can understand it better than have I have described it, but I am 90% sure it does not involve removing the disc.

My doctor, Dr Grossman, gave me the analogy that if you dislocate your shoulder, you donít just leave it hanging there out of its socket but rather put it back in its correct position for it to correctly heal, likewise its his belief that this is what should happen in case s where the tmj disc is dislocated. His surgery/qualifications details can be found here if you are interested :
[website removed]

A bit of information from his site mentions the following which I feel is quite relevant :

His interest in the treatment of patients with cranio-facial pain and jaw joint dysfunction was stimulated by his late father, Dr W. Grossmann, Consultant Orthodontist, University College Hospital and Professor James Moss. Over the last fifteen years he has had a very close working relationship with Dr Brendan Stack, DDS, Washington DC, co-founder of the American Academy of Craniofacial Pain, who is widely regarded as one of the foremost practitioners in this field.

Again thanks for taking the time to reply, its very much appreciated.


[QUOTE=Cymy Sue]Hi davec,

I'm not sure what a modified meniscoplasty, "is" exactly....

I assume it means removal of the disc in some manner, because they cannot be repaired. (Dr. Stack's report) I did try to reseach this and couldn't find an explanation of the procedure. I could be on the wrong track here, if so, I apologize.
The closest I could come to an explanation was, removing the disc without disturbing or injuring the surrounding tissue, bone, etc.

I had a bilateral discectomy or menisectomy, 7 years ago. Removal of both disc. Proper follow-up care was a brief period of PT and meds.
Splint therapy was not included and even discouraged. I suffered terribly for 5 years, finally found splint therapy designed for this condition (as Dr. Stack indicates "IS" necessary) and am doing extremely well now.

Removal of deteriorated or irrepairable disc has become, in the last few years, more accepted as the appropriate step. When I had it done, it was my only option. It seems the Medical Profession has learned a great deal since then. It was rough, at the time I had this done.

The surgeries that you see many write about and are discussed as being terribly invasive and damaging include almost all that can be done for TM joint problems. The members who got into these surgeries 10-15 & 20 years ago and have continued to have surgery after surgery, have written much about these procedures and the failures. Myself included.

We were, in reality, having procedures that in theory should work, but didn't.
Some of us had terribly invasive procedures done before C-scans & MRI's were used to assess the problem or the damage we had. Some had implants that had not been fully tested and approved by the FDA.

I had 2 orthognathics (bone restructuring) for TMJ in 1988. I didn't have any deformities or even bad occlusion, but they thought creating a different "bite" would cure the problem. This was done without (MRI) or other imaging of the joints.

Once, MRI's became common within the next year or so, it was determined my disc were deteriorated beyond repair, my joint capsule was abnormal, and the first 2 procedures had been useless and caused more trauma.

I had to have bone grafts (maxilla & mandible) due to infection from these procedures.

In the early 90's they were doing autogenous grafts to replace disc. I had an open joint procedure (Arthroplasty) to replace mine with ear cartilage. They used and are still using cartilage and muscle grafts, but they know (now)these materials do not last. Statistic's say 2-5 years normally. Mine started to deteriorate after 2 years. There are reports that some have lasted longer.

In 1997, I had another Arthroplasty to remove the replacements and nothing put in. They believed this was the best option at that time. They just didn't know how to help your body and muscles adjust to being without disc. (I also have very little left of my condyles and the joint capsule has never been normal)

All total, I have had 7 surgeries because of TMJ and the only one I really should have had was, the removal of the disc.
With the proper follow-up care, I believe (now) it was the best thing for me. It just took a while to get the follow-up care I needed.
I have nerve & muscle damage & bone loss due to the earlier procedures. My TMJ treatment began in 1977 and I still wear a very small & comfortable splint at night to keep the muscles from spasming.

There are others who have had many more arthroscopic & arthroplastic procedures, than I did. They are still looking at more surgeries to try to get where I am now. Out of pain and functional.
Many people had faulty plastic or metal implants and they are, by far, having the greatest problems.
Some of the later, metal based implants are reported to be working for some people.

All of these procedures performed on the TM joints do carry risks as most surgeries do. There is always the possibilty of nerves being damaged or the unforseen happening. Find out everything you can about this procedure and be aware.

Again, if I'm on the right track at all, having the disc removed, does seem to have been improved and refined. It does seem to be the best option when there is no hope of saving the disc.

If I had to do it again, I would, with a Surgeon who knew the appropriate after-care that is absolutely required.

Let me know if this has helped or if this procedure is something totally different. I would be very interested in what it is, if not a refinement of the original Discectomies.

Cymy Sue[/QUOTE]





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