Abstract
Arthrogryposis is defined as limited range of motion in three or more joints in two or more body parts. This article will describe treatment options for the arthrogrypotic knee. In all types of arthrogryposis, and in both extension and flexion deformities, very early treatment is favorable. Just after birth, traction and mobilization followed by serial casting could often greatly improve the range of motion. In the hyperextended knee, surgical lengthening of the extensor apparatus may be needed. Flexion deformities could be improved with temporary physeal arrest of the anterior distal femur by fixing two-hole plates over the physis on both sides of patella. The plates will result in a constrained growth of the anterior physis, and thus a very slow extension of the knee, which will give the nerves and vessels time to adjust. Pterygium, webbing of the knee joint, is a special subgroup that in selected mild cases could be treated with extensive surgical release of the webbing and orthotics. Arthrogrypotic knees can be treated with early reduction and maintenance with orthotics.
Highlights
Arthrogryposis is defined as limited range of motion in three or more joints in two or more body parts
Arthrogryposis is defined as motion limitation of three or more joints in different parts of the body, so joints other than the knees are involved in arthrogryposis [1]
Arthrogryposis was treated by surgery alone, and approximately 6 surgeries were needed per child [2]
Summary
Common to all congenital flexion contractures, when it is not possible to extend the knee to 0°, very early treatment gives better results. 8-plates can be applied over the ventral physis of the distal femur [7]. Palocaren et al used 8-plates for 10 children (4–10 years old) with arthrogryposis and knee flexion deformities. When applying 8-plates for flexion deformities of the knees, one has to make two arthrotomies, one on either side of the patella. A new metaphyseal screw can be applied to the plate that has been left in the knee, guiding the growth into extension a second time. Not uncommonly there is a risk of neurovascular trauma with, e.g., hyperesthesia of the feet as a sign of nerve injury This is not seen with the gradual effect of the 8-plates. Repeated serial casting is a nonsurgical option which has a limited risk for neurovascular complications
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
