Background: We undertook a review of the literature to assess the role of temporomandibular joint (TMJ) replacement (TMJR) in maxillofacial trauma and examined our own experience of temporomandibular joint bony complications. Methods: A scoping review of (I) a systematic literature research performed for the German evidence and consensus based (S3) guideline on total joint replacement, (II) a recent systematic review and meta-analysis by Niezen et al. [2022] (comprising 13,093 patients and 20,860 prostheses), (III) a systematic literature review of PubMed, google scholar and Cochrane database between November 2021 and February 2022 including English and German studies. In addition, we evaluated our cohort of surgically treated condylar fractures (n=604; head fractures: n=405 since 1993; neck and base fractures: n=199 since 2007) regarding complications which may potentially necessitate a TMJR.Results: Our search identified 8 studies including 10 patients in addition to the 83 cases found by Niezen et al. Although many reports on TMJR describe trauma as an aetiological factor, overall, merely 4 cases received an alloplastic TMJR as a primary treatment. Three cases met the criteria for an early secondary treatment within 6 months, 9 cases after 6 months past trauma. None of the surgically treated condylar fractures (n=604) in our cohort required joint replacement. Within the condylar head dataset (n=405) there was a significant correlation (P<0.05) between the presence of major fragmentation (n=52) and bony complications (n=23, 5.7%) such as osteoarthrosis, pseudarthrosis and heterotopic ossification (HO)/ankylosis. HO (n=9) correlated with delayed surgical treatment (>10-14 days, P<0.01). There was a significant correlation between subjective borderline feasibility of osteosynthesis (n=12/270, 0.4%) and major fragmentation (P<0.001), severe comminution (P<0.001), multilevel fractures (P<0.001) and severe osteoporosis (P<0.001). Conclusions:In contrast to orthopedic practice alloplastic TMJR does not play a noticeable role in primary or early secondary condylar fracture management. There may be indications in selected cases of major fragmented fractures where safe and stable osteosynthesis is not feasible. Most condylar fractures if treated according to best practice should not result in significant bony complications, but those that do may ultimately require further intervention including TMJR.