Muscle and joint function in children living with arthrogryposis multiplex congenita: A scoping review

Am J Med Genet C Semin Med Genet. 2019 Sep;181(3):410-426. doi: 10.1002/ajmg.c.31726. Epub 2019 Jul 27.

Abstract

Arthrogryposis multiplex congenita (AMC) is characterized by congenital joint contractures present in two or more body areas. Lack of fetal movement is the underlying cause of AMC, which can lead to abnormal connective tissue surrounding the joint resulting in stiffness and muscle atrophy. Treatment aims at improving function and mobility through surgical and/or conservative interventions. A scoping review was conducted to explore the existing knowledge of the evaluation and treatment of muscle and joint function in children with AMC. Three search engines were included and identified 1,271 articles. Eighty-seven studies met the selection criteria and were included in this review. All included studies focused on joints, 30 of which also assessed the muscle. Assessment most often included the position of the contractures (n = 72), as well as range of motion (n = 66). Interventions to improve muscle and joint function were reported in 82 of the 87 papers and included surgery (n = 70) and conservative interventions (n = 74) with bony surgery (i.e., osteotomy) the most common surgery and rehabilitation the most common conservative intervention. Recurrences of contractures were mentioned in 46 of the 68 studies providing a follow-up. Future studies should use validated measures to assess muscle and joint function, and conservative interventions should be described in greater detail and to include a longer follow-up.

Keywords: arthrogryposis multiplex congenita; joint; management; muscle; pediatric.

Publication types

  • Review

MeSH terms

  • Arthrogryposis / physiopathology*
  • Child
  • Humans
  • Joints / physiopathology*
  • Muscles / physiopathology*
  • Range of Motion, Articular / physiology