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TMJ

(52) Retrospective Analysis of Heterotopic Ossification in Zimmer Biomet and TMJ Concepts

Thursday, September 21, 2023
1:30 PM – 3:00 PM PDT
Disclosure(s):
Alexander Y Z Li, DMD: No financial relationships to disclose
Abstract:

Purpose:
This is a retrospective cohort study to review all the cases in which patients have undergone alloplastic TMJ reconstruction from 2011-2021 at the Hospital of University of Pennsylvania. The primary objective is to determine the heterotopic ossification incidence between two competing FDA-approved alloplastic implants (Zimmer-Biomet© and TMJ Concepts©), and secondary endpoint to perform statistical analysis to identify the risk factors of heterotopic ossification.

Materials and

Methods:
The selected cohort included patients who have had at least one temporomandibular joint replacement and/or revision during the surgical catalog period from 2011 to 2021, determined by CPT billing codes 21243 (arthroplasty, TMJ, with prosthetic joint replacement). Patients that were not treated by attendings from Penn Center for TMD as well as those that passed away were excluded from the selected cohort.

Results:
During the decade, a total of 373 TMJ replacements (TMJR) and TMJ revisions (TMJREV) were performed in 262 patients, with an average age of 45 years. The majority of patients who underwent TMJR/TMJREV did not have inciting incidents nor previous TMJ surgeries. The incidence of heterotopic ossification was found to be in total of 12.6% of all patients, with the most common location in the mandibular condyle.

Conclusions:
Patients who underwent total joint replacement have low likelihood in contracting heterotopic ossification. The pathogenesis of heterotopic ossification is complicated in the temporomandibular joint as it may involve trauma, inflammation, and hypoxia. Successful TMJ reconstruction requires multidisciplinary care including oral and maxillofacial surgeons, pain specialists, internists, physical therapists, and general dentists in order to optimize patient outcome.

Penn Medicine TMJ Surgery for Total Joint Replacement Chief Complaint Incident Distribution
Recordings for MIO (mm) and Pain Score (0-10) at Follow-Up Time Periods (months)
Rate of Heterotopic Ossification Formation as Function of Discovery Time (year)