Arthrogryposis: Treatment, Cost and Side Effects

Arthrogryposis is a medical condition characterized by congenital joint contractures in two or more joints before birth. Joint contracture is a condition where a joint becomes fixed permanently in an abnormal, bent, or straight position. Arthrogryposis refers to this happening in multiple joints simultaneously before birth, causing the affected joints to lose their normal range of mobility as well as muscular atrophy. Arthrogryposis is not a condition in itself, but a symptom of other conditions. Arthrogryposis is seen to have been inherited in about 30% of cases through autosomal dominant, autosomal recessive, or X-linked inheritance depending on the condition causing the symptom. Sometimes environmental factors together with genetics cause this condition to develop.

Arthrogryposis is thought to be caused by limited foetal movement inside the womb, which causes tendons to form abnormally and extra connective tissues to develop around the joints, fixing them in that shape. Decreased foetal movement may occur due to abnormal formation of the foetal musculature, tendons, or ligaments due to diseases affecting the mother or the child, lack of sufficient space inside the uterus due to multiple pregnancies, uterine structural anomalies, etc. It may also occur due to abnormal formation of the foetal central nervous system, in which case, other conditions also develop together with arthrogryphosis.

In mild cases, arthrogryphosis does not cause significant loss of mobility. However, in severe cases, the condition may affect all the joints in the body, including the spine and the jaws.

Treatment for arthrogryphosis depends on the extent of the condition and the joints affected. The condition is congenital and hence detectable at birth. Physiotherapy is started early after birth to stretch the joint contractures to increase their range of movement as well as to prevent muscular degeneration. Physiotherapy and occupational therapy is beneficial in most cases to improve and maintain joint motility and musculature, even though it cannot be cured completely. In severe cases with very extensive contractures where physiotherapy shows no results, surgery is performed to correct the alignment of joints, muscles, and tendons to help increase the mobility of the joint. Tendon transfer has also been performed in some rare cases.

Arthrogryposis causes multiple joints to become permanently fixed while straight, bent, or at an abnormal angle before birth. Treatment is necessary if the condition severely affects movement of multiple joints and day to day life.

In mild cases, arthrogryposis only affects joints mildly and does not cause significant loss of joint mobility. Rigorous treatment need not be followed in these cases.

Almost no side effects are associated with treatment for arthrogryposis. Only in rare cases can complications arise from surgery.

There are no specific post treatment guidelines. Arthrogryposis is a condition which cannot be cured completely. Only the range of mobility of affected joints can be improved and maintained, and muscular atrophy can be prevented with regular physical therapy.

Complete recovery does not take place. Only joint movement can be improved and maintained with regular physical and occupational therapy.

Price of treatment starts from Rs. 1000 for physical therapy sessions, and may go up to Rs. 20,000 or higher for surgical procedures.

Results of the treatment are not permanent and regular physical and occupational therapy sessions are required to maintain joint mobility and prevent muscular degeneration.

Alternative treatment options for arthrogryposis include home remedies and traditional medications, although their efficacy in treating the condition is unclear. Group therapy with support groups may be helpful in helping the patient to deal with the psychological aspects of the condition.