" I had a Teflon implant removed from my TMJ joints in 1987 which had been implanted in 1984. At the time there seemed to be no negative reaction although the surgical report stated foreign body reaction had been observed. Unfortunately I was involved in a car accident complications from which affected the TMJ requiring grafting of rib material to reconstruct the jaw.
My question is: Are there any tests to see if the teflon residue can be detected in either the tissue removed in the later surgery or even now post surgically (there seem to be some complications in the right joint)."
A TMJ implant, which was made out of a Teflon-Proplast material and used as a meniscus replacement. With hindsight severe degenerative changes occurred in about 90% of cases.
The implant disintegrated under load, producing a foreign body giant cell reaction , subsequent bone erosion and lymphadenopathy.
Vitek withdrew the implant and went into liquidation. The U.S. Food and Drug administration subsequently produced a consensus statement advising the removal of all symptomatic implants and 6 monthly radiographic follow up of asymptomatic patients. Once the source of the inflammatory response is removed then the migration of this tissue to the lymph nodes ceases.
A foreign body reaction is seen after any implantation of any alloplastic material and is a chronic inflammatory response. However if the response is low grade and produces no symptoms then no action is necessary. There are analogies here with the similar response to reactions to implantible silicone breast implants.
Unfortunately the search for a biocompatible TMJ implant has not produced any serious contenders and in the UK most TMJ reconstructions are performed with autografts of cartilage capped rib (costochondral grafts) or new menisci are formed by using interpositional muscle or dermal grafts. The main prosthetic TMJ under consideration in the UK is the Christensen prosthesis composed of a cobalt-chrome articular fossa and a methyl methacrylate condyle replacement attached to a cobalt chrome ascending ramus. However there appear to be no long term solutions to the multiply operated patient and only about 5% of all patients treated for TMJ disorders undergo open TMJ surgery.
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