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Autologous fat grafting29111or TMJ Concepts total joint prosthesis. While the increase in MIO with 3.5 mm was somewhat disappointing for the Christensen system, the TMJ Concepts system showed an increase of 6.8 mm in MIO. Neither of the prostheses developed heterotopic bone formation that could be seen on radiographic images, nor did they report any donor site-specific complications such as the development of a seroma or infection.The treatment efficacy of TMJ total joint replacement (TJR) with periarticular AFG in patients who had recurrent TMJ ankylosis was studied by Mercuri et al.(7) in 2008. They included a total of 20 patients, totaling 33 joint replacements, with a mean follow-up of 50.4 ± 28.8 months. While they found a significant reduction in pain, an improvement in quality of life (QoL), and an increase in MIO, no report on the recurrence of heterotopic bone formation was made.Shanyong et al.(4) performed a retrospective single-center study involving 15 patients and 19 TMJ, to evaluate three modifications to the TMJ replacement technique. Among them was the use of an AFG harvested from the subcutaneous fat, to prevent fibrosis and heterotopic bone formation, by filling up the periprosthetic dead spaces. They concluded that in patients where AFG was used, there was no clinical nor radiographic sign of periprosthetic bone formation, while the two joints which were not treated with AFG showed the formation of heterotopic bone.Wolford et al.(5) published another study in 2016 to address the treatment of TMJ ankylosis by placement of a TMJ TJR combined with AFG in 32 patients. This treatment proved to be successful, resulting in a significant increase in QoL, MIO, lateral extrusion, and jaw function, as well as decrease in pain. Furthermore, only 2 of 32 patients developed heterotopic bone formation. It is interesting to remark that both patients had been previously treated with a Vitek–Kent system. In 2016, Selbong et al.(6) described three cases with heterotopic bone formation around a TMJ TJR. They removed the prosthesis, resected the heterotopic bone, and replaced the prosthesis, packing the articulating surface with AFG. No reoccurrence of heterotopic bone was reported.Nikolas de Meurechy NW.indd 291 05-06-2024 10:15