Mandibular condylectomy and meniscectomy for the treatment of septic temporomandibular joint arthritis in a horse.
OBJECTIVE
To report use of mandibular condylectomy for treatment of advanced degenerative joint disease of the temporomandibular joint (TMJ) caused by sepsis.


METHODS
Clinical case report.


METHODS
Two-year-old Noriker filly.


METHODS
Computed tomography (CT) was used to confirm advanced degenerative joint disease of the left TMJ and for follow-up after mandibular condylectomy and removal of necrotic meniscus.


RESULTS
Painful swelling (3 weeks duration) with drainage located just caudal to the left lateral canthus of the eye was associated with atrophy of the left masseter muscle, masticatory problems, and inappetence. There was incisor malocclusion with a 1.4 cm resting lateral mandibular deviation to the right and inability to open the mouth more than a few centimeters. Left mandibular condylectomy combined with meniscectomy and thorough debridement of the septic left TMJ resulted in resolution of clinical signs and complete return of function. Streptococcus zooepidemicus, intermediately resistant to penicillin and subsequently to enrofloxacin, was isolated from the wound. Regeneration of a mandibular "pseudocondyle" was evident on CT at 4 months. At 4 months and 1 year the filly had maximal mouth opening >10 cm and no malocclusion.


CONCLUSIONS
Mandibular condylectomy can be used to facilitate management of septic TMJ arthritis. There was no radiologic or clinical evidence of TMJ ankylosis >1 year after meniscal removal.


CONCLUSIONS
Mandibular condylectomy, including meniscectomy, is an acceptable treatment option for advanced TMJ septic arthritis and allowed return of normal masticatory function.
Nagy
Amy Dae
AD
Clinic for Surgery and Ophthalmology, Equine Department, University of Veterinary Medicine, Vienna, Austria. adnagy@vt.edu
Simhofer
Hubert
H
D000818:Animals; D001170:Arthritis, Infectious / Q000382:microbiology / Q000601:surgery / Q000662:veterinary*; D001182:Arthroscopy / Q000379:methods / Q000662:veterinary; D003646:Debridement / Q000379:methods / Q000662:veterinary; D005260:Female; D006734:Horse Diseases / Q000382:microbiology / Q000601:surgery*; D006736:Horses; D008335:Mandibular Condyle / Q000601:surgery*; D008409:Mastication / Q000502:physiology; D013290:Streptococcal Infections / Q000601:surgery / Q000662:veterinary*; D018502:Streptococcus equi / Q000302:isolation & purification*; D013705:Temporomandibular Joint Disorders / Q000382:microbiology / Q000601:surgery / Q000662:veterinary*; D016896:Treatment Outcome