Total Joint Replacement

Total joint replacement is a surgical procedure in which parts of an arthritic or damaged joint are removed and replaced with the patient’s own tissue, metal, plastic or ceramic device called a prosthesis. The prosthesis is designed to replicate the movement of a normal, healthy joint.

In the growing patient, local tissue replacement may be utilized such as the costochondral graft (rib), fat and other compatible tissues.

Today, alloplastic total joint replacement (fabricated custom prosthesis) is the treatment of choice in the adult patient. Alloplastic is a custom CAD/CAM designed and fabricated prosthesis. This is indicated in cases of severe degeneration with severe refractory pain, changes in the bite (occlusion), progressive facial asymmetry or limited range of motion or immobility as in the case with ankylosis where the mandible is fused to the cranial base by bone. This procedure is a highly technical one and very few surgeons offer this modality of care. Dr. Gilbert is one of the few OMF surgeons with experience offering this service to patients in need.

Each prosthesis is individually fabricated for the unique anatomy of the patient. Customizing the alloplastic joint replacement fit allows for excellent adaptation to these discrepant features providing maximum fixation and optimum function. All of the materials utilized for manufacturing these implants (titanium, cobalt-chromium-molybdenum, and ultra-high-molecular-weight polyethylene) have several decades of successful clinical use in the reconstruction of hip and knee joints.

When might I benefit from this Alloplastic joint replacement?

You may benefit from alloplastic joint replacement if you suffer from one of the following conditions.

  • Inflammatory arthritis (such as rheumatoid arthritis) of the TMJs not responsive to other treatment
  • Immobility of the joints (fibrous and/or bony ankylosis) not responsive to other treatment
  • Failed TMJ reconstructions using body tissue such as bone, muscle, or cartilage
  • Failed TMJ reconstructions using joints or other implants made from man-made materials
  • Loss of correct jaw position due to bone loss (resorption), trauma, developmental abnormality, or tumor


 Ankylosis of the mandible (blue) and exuberant bone (green and magenta) to the cranial base


Computerized planning of bone fusion resection

 Stereo-lithographic model of the resection plan

Final custom total joint and mandibular augmentation prosthesis