I like blogging about what I experience on a day-to-day basis, so this one is about a patient I followed up on this week who had severe TMJ arthritis and was contemplating a joint replacement. She was eating only smoothies, so how did she do and what did we do to help her? Let’s dive in.
What Is TMJ Arthritis?
The TMJ is your jaw joint. It can get arthritis like any other joint, and those issues are frequently associated with upper neck problems. The joint has a meniscus spacer like the knee as well as strong ligaments that hold it in place. When the arthritis is mild, dentists will often inject steroids (which can be harmful in the long run but help in the short run) into the joint or use specialized mouthpieces called splints. When arthritis gets severe, TMJ replacement is often the only option.
Is TMJ Replacement the Only Solution?
One of the issues we often hear from patients who get or are researching TMJ replacement is that the surgery is hit or miss. In addition, this is a big surgery, with one recent university study showing about a 5% infection rate that required surgical removal of the prosthesis. In addition, another recent research study discussed that TMJ implants can produce similar adverse tissue reactions to hip replacement implants. Yet another study found that about one-third of patients who got a TMJ replacement surgery on one side and had TMJ issues on the other needed to have the other side replaced, likely due to abnormal loading.
We have been treating arthritic TMJs for many years with both platelet-rich plasma as well as stem cells. We produced this video a while back about one patient’s experience with the stem cell procedure on both her TMJ and upper neck:
Kim’s TMJ Journey
Kim is 49 years old with right-sided TMJ and was told that she was “bone on bone” and needed a TMJ replacement. She talked to friends and others who had the surgery, and despite what she was being told by the maxillofacial surgeon, she heard more about bad results than good ones. When I first evaluated her, she was on a liquid diet and was only eating smoothies. This caused her to lose about 10–12 pounds.
Her CT scan of the area from her health plan (Kaiser) showed severe TMJ arthritis. This included big bone spurs plus a change in shape of the mandible part of the joint. Kim had a Regenexx SD TMJ procedure performed, which used her own bone marrow stem cells to treat the joint, surrounding ligaments, and tendons. This is a technically demanding procedure that requires both ultrasound and X-ray guidance using C-arm fluoroscopy.
How did she do? I saw her back this week at five months out from her procedure. She reports that she’s 90% better without surgery, just the precise stem cell injection procedure. She’s switched from smoothies to eating mostly what she wants, including hard food, although she avoids a few things that are hard and chewy. We plan to do one more follow-up platelet-based procedure, and then we’re likely done for now.
The upshot? We have seen great results in helping TMJ patients avoid surgery. Given the invasiveness of TMJ replacement, this can be a great option for patients.