The vascularized medial femoral condyle osteochondral flap for temporomandibular joint reconstruction: A study of medium-term outcomes.

Abstract

Defects of the temporomandibular joint (TMJ) severely compromise mandibular function and facial contour, rendering its reconstruction one of the most challenges in maxillofacial surgery. This study introduced a novel technique for TMJ reconstruction employing vascularized medial femoral condyle (MFC) osteochondral flap and aimed to evaluate its medium-term functional outcomes and stability. This observational study included 15 patients who received vascularized MFC osteochondral flap reconstruction for TMJ ankylosis or neoplasms. The follow-up ranged from 12 to 69 months (median:24 months). The average of postoperative maximal mouth opening (MMO) was significantly increased compared with the pre-operation in patients with TMJ ankylosis (p = 0.0039). The postoperative MMO in patients with TMJ neoplasms was comparable with preoperative (p = 0.2500). The average ramus height remained stable in both TMJ ankylosis (p = 0.1875) and neoplasms (p = 0.8125) without significant difference. All donor sites healed favorably, with Lower Extremity Functional Scale (LEFS) scores ranging from 70 to 80 (maximum 80). According to medium-term follow-up results, the medial femoral condyle flap is a safe and reliable method for the reconstruction of TMJ defects.