Donor site morbidity after the harvest of microvascular flaps from the medial and lateral femoral condyle region: Objective, radiologic, and patient-reported outcome of a multi-center trial

Neuwirth, Maximilian; Ziegler, Thomas W.; Benedikt, Stefan; Winter, Raimund; Kamolz, Lars Peter; Schintler, Michael; Rab, Matthias; Mueller-Eggenberger, Michael; Mischitz, Madeleine; Palle, Wolfgang; Hoenck, Karina; Schoellnast, Helmut; Janek, Elmar; Borenich, Andrea; Buerger, Heinz

doi:10.1016/j.bjps.2021.08.028

Cited by 2 publications

(1 citation statement)

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“…The cortical bone in the LFC is thicker than the MFC, which is desirable in a loaded joint such as the TMJ (Wong et al, 2015). Both flaps are less invasive than other bony flaps from the lower limb, and the donor site morbidity is negligible (Neuwirth et al, 2022). When used for TMJ reconstruction, the LFC and the MFC flap are anastomosed to the temporal vessels, which are readily available and near the joint.…”

Section: Discussionmentioning

confidence: 99%

The condylar capping for microvascular temporomandibular joint reconstruction: A preliminary study

et al. 2022

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Background Defects of the temporomandibular joint (TMJ) are often difficult to be reconstructed in the correct dimensions and function. This preliminary study aims to describe a novel technique of condylar reconstruction with a microvascular flap in case of deforming arthrosis of the TMJ: condylar capping. Patients and Methods Four patients between 22 and 62 years old—three females and one male—with severe unilateral arthrosis of the TMJ underwent condylar capping. All patients had already had a failed conservative treatment, followed by arthroscopy with lysis and lavage and later open surgery with total or subtotal diskectomy combined with a condylar arthroplasty. Nevertheless, their pain was still at level six or more on a visual analogue scale. Moreover, they could eat only soft food. At this stage, they underwent condylar capping using an osteochondral lateral femoral condyle (LFC) flap. The surgical technique and the postoperative management are described in detail. Crucially the attachment of the lateral pterygoid muscle to the condylar neck was preserved in all cases. The patients were followed up clinically and by CT scan preoperatively, 6, and 12 months postoperatively. Results The mean height of the reconstructed neo‐condyle was 6.0 mm, the mean width 16.2 mm, and the mean sagittal length 9.8 mm. The follow‐up period ranged from 14 to 64 months. The procedures were uneventful for all patients, and the donor site morbidity was negligible. Twelve months later, the patients were all pain‐free and able to have a regular diet. The TMJ and the knee had a normal range of movement and power. Postoperative imaging demonstrated bone healing and stable and anatomically correct condyle reconstruction. Conclusions Based on the author's experience, the condylar capping with the LFC appears promising for reconstructing the condylar head in cases of severe osteoarthritis. Preserving the attachment of the lateral pterygoid muscle allows a complete restoration of the physiologic range of movement, including protrusion and laterotrusion of the mandible.

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Section: Discussionmentioning

confidence: 99%