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Muscle and joint function in children living with arthrogryposis multiplex congenita: A scoping review
Marianne Gagnon1,2, Kevin Caporuscio3, Louis-Nicolas Veilleux1,2
1Shriners Hospital for Children-Canada, Montreal, Québec, Canada.
Insights
Arthrogryposis multiplex congenita (AMC) involves joint contractures due to lack of fetal movement. This review highlights surgical and conservative treatments for AMC, emphasizing the need for validated measures and longer follow-ups.
Area of Science:
- Pediatrics
- Orthopedics
- Rehabilitation Medicine
Background:
- Arthrogryposis multiplex congenita (AMC) is a condition characterized by congenital joint contractures affecting multiple body areas.
- It stems from reduced fetal movement, leading to joint stiffness and muscle atrophy.
Purpose of the Study:
- To conduct a scoping review of existing knowledge on the evaluation and treatment of muscle and joint function in children with AMC.
- To identify common assessment methods and interventions used for AMC.
Main Methods:
- A comprehensive literature search was performed across three search engines, identifying 1,271 articles.
- Eighty-seven studies met the inclusion criteria, focusing on joint and muscle function assessments and interventions in AMC patients.
Main Results:
- The most frequent assessments included contracture position (n=72) and range of motion (n=66).
- Surgery (n=70), particularly bony surgery like osteotomy, and conservative interventions (n=74), primarily rehabilitation, were commonly reported.
- Contracture recurrence was noted in 46 of 68 studies with follow-up.
Conclusions:
- Current evaluations for AMC primarily focus on joint position and range of motion.
- Surgery and rehabilitation are the mainstays of AMC treatment, though contracture recurrence is common.
- Future research should prioritize validated assessment tools, detailed descriptions of conservative interventions, and extended follow-up periods.
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.
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