53220 - TMJ Arthrotomy

The need for arthrotomy of the temporomandibular joint (TMJ) arises when a patient experiences severe TMJ dysfunction—such as locking, pain, or structural damage—due to conditions like advanced arthritis, ankylosis, or large intra-articular masses, requiring open surgical access under anesthesia with assistance in a hospital to address issues not manageable by arthroscopy or other grouped procedures. This standalone procedure is indicated for significant TMJ pathology needing direct intervention, critical in the maxillofacial region where joint health affects jaw movement and comfort.

Several scenarios necessitate this intervention:

• Ankylosis: Bony fusion of the TMJ from trauma or infection might prevent mouth opening, requiring arthrotomy to break the fusion and restore motion.
• Severe arthritis: Advanced osteoarthritis with eroded cartilage could cause debilitating pain and stiffness, needing open surgery to clean or reshape the joint.
• Large masses: A sizable tumour or cyst within the TMJ might exceed arthroscopic capabilities, prompting arthrotomy for complete removal.
• Structural damage: Significant disc or condylar damage from chronic dislocation might require direct repair to regain function.

For instance, a patient with TMJ ankylosis from a childhood injury might undergo arthrotomy to cut through the fused bone and restore jaw opening, with the assistant ensuring precise access near facial nerves. In an aged care context, an elderly patient with severe arthritis causing constant TMJ pain could need this to improve chewing, adjusted for their frailty and joint degeneration. By opening the joint surgically, this service addresses complex pathology, restores mobility, and alleviates pain, making it an essential open surgical option for severe TMJ issues within the maxillofacial framework.

Restores severe TMJ function, relieves significant pain, and corrects structural damage.

Recovery of 4-6 weeks with swelling, jaw therapy, and restricted motion; hospital stay required.