EVALUATION OF TMJ MENISCUS REPLACEMENTS IN PRIMATES

颞下颌关节外科治疗的发生率 在美国，内部混乱正在加剧。使用的标准 用于选择手术候选人识别患有非 复位前脱位或严重受损的椎间盘为 那些对手术矫正反应最快的 颞下颌关节(TMJ)内部排列紊乱。当一个 半月板切除手术，外科医生需要 防止骨与骨接触的介入性材料 髁状突头骨关节窝及其后遗症 退化性变化。临床医生目前使用的材料 包括冻干原胶-聚合物层压板、硅橡胶 硬膜，或真皮移植物。优点(即组织向内生长， 生物相容性、纤维组织替代或化生)和 缺点(如滑脱、异物反应、缺乏 强度)的这些材料还没有直接比较 客观、合适的动物模型。 为了对比通常被认为是 使用并代表两个主要的重建 半月板切除术患者的关节窝哲学 表面重铺材料(原形聚合物)或半月板替代物 将被用来检验这些哲学上的不同 重建模式。15只短束猕猴 将接受单侧TMJ半月板切除术。要么是原生生物- 聚合物层压板，真皮移植，或不替换(对照)将 被插入。动物将只接受左侧的植入物 TMJ。单侧手术将能够检查一个TMJ 没有来自相反的TMJ的贡献。此外， 未手术的关节将被用来确定单侧的效果 未手术的对侧TMJ手术。四个月后 外科手术动物将被牺牲用于临床、放射学检查 并进行组织学评价。这项初步研究的结果应该是 为准备一项更大规模的研究提供足够的信息。

The incidence of surgical treatment for temporomandibular joint internal derangement is increasing in the U.S. The criteria used for selecting surgical candidates identifies patients with non- reducing anterior dislocated discs or severely damaged discs as those most responsive to surgical correction of temporomandibular joint (TMJ) internal derangements. When a meniscectomy is performed, the surgeon requires an interpositional material to prevent bone to bone contact between the condylar head and bony glenoid fossa and subsequent degenerative changes. Materials currently used by clinicians include Proplast-polymer laminates, silicone rubber, lyophilized dura, or dermis grafts. The advantages (i.e. tissue ingrowth, biocompatability, fibrous tissue replacement or metaplasia) and disadvantages (i.e. slippage, foreign body reaction, lack of strength) of these materials have not been directly compared in an objective and appropriate animal model. In order to compare interpositional materials that are commonly used and represent the two predominant reconstructive philosophies for meniscectomy patients, a glenoid fossa resurfacing material (Proplastpolymer) or a meniscus substitute will be used to examine these philosophically different reconstructive modalities. Fifteen Macaca fascicularis monkeys will undergo unilateral TMJ meniscectomy. Either a Proplast- polymer laminate, a dermis graft, or no replacement (control) will be inserted. The animal will receive the implants on only the left TMJ. Unilateral surgery will enable examination of one TMJ without contributions from the opposite TMJ. In addition the unoperated joint will be used to determine the effect of unilateral surgery on the unoperated contralateral, TMJ. Four months after surgery the animals will be sacrificed for clinical, radiographic and histologic evaluation. The results of this pilot study should provide sufficient information for preparation of a larger study.