Page 220 - Demo

Chapter 8218The incision below the zygomatic arch was used to dissect the joint space and insert the cutting guide to ensure that the condylectomy identical to the virtual planning. During the condylectomy, an attempt was made minimally preserve the BTJ of the LPM (i.e., the enthesis), as well as some of the adjacent condylar bone by partially resecting the condyle and then threading a PDS 0 suture (Ethicon, Somerville, NJ, USA) through the tendon of the LPM, after which the remainder of the condyle, apart from the BTJ and adjacent bone, was resected. This step proved challenging. Humans have a larger bony insertion area of the LPM, whereas sheep have a small and mostly fibrotic insertion into both the intra-articular disc and condyle. Thus, the condylar bone and BTJ could only be preserved in six cases. In seven cases, only the BTJ or fibrocartilaginous part of the muscle insertion could be preserved. In two cases, it was unclear whether either the BTJ or even MTJ was preserved (Table 1).Table 1: Per-operative reconstruction and post-mortem radiological analysis between the lateral pterygoid muscle (LPM) and the implant scaffold.Sheep nr Per-operative Post-mortem3520 Bony Fibrotic8087 Unclear Bone2177 Bony Absent5158 Unclear Bone + Fibrotic2549 Fibrocartilaginous Absent4249 Fibrocartilaginous Bone0032 Fibrocartilaginous Fibrotic 7998 Bony Absent4246 Bony Bone + Fibrotic1724 Bony Fibrotic 4248 Bony Bone + Fibrotic8787 Fibrocartilaginous Absent4473 Fibrocartilaginous Absent0075 SHAM SHAMNikolas de Meurechy NW.indd 218 05-06-2024 10:14