Article

Arthrogryposis includes heterogeneous disorders, characterized by congenital
contractures of multiple joints. Knee involvement is very common (38-90 % of
patients with amyoplasia) ranging from soft-tissue contractures (in flexion or
hyperextension) to subluxation and dislocation. Flexion contractures are more
common and disabling and show significant resistance to treatment and rate of
recurrence. Surgical procedures vary with severity of contracture and patient age
and include soft-tissue release, femoral shortening-extension osteotomy, gradual
correction with Ilizarov, and femoral anterior epiphysiodesis. The presence of
pterygium greatly complicates treatment, given the high rate of complications
reported. Hyperextension deformities (recurvatum, anterior subluxation, and
dislocation) have better prognosis for walking ability. Surgical options include
percutaneous (or mini-open) quadriceps tenotomy, open quadricepsplasty, and
femoral shortening osteotomy with limited arthrotomy. Knee dislocations usually
require surgery and should be reduced early.

Langue : ANGLAIS