Management of arthrofibrosis in neuromuscular disorders: a review

Arthrofibrosis, or rigid contracture of major articular joints, is a significant morbidity of many neurodegenerative disorders. The pathogenesis depends on the mechanism and severity of the precipitating neuromuscular disorder. Most neuromuscular disorders, whether spastic or hypotonic, culminate in...

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Bibliographic Details
Published in:BMC musculoskeletal disorders 2022-07, Vol.23 (1), p.1-725, Article 725
Main Authors: Martinez-Lozano, Edith, Beeram, Indeevar, Yeritsyan, Diana, Grinstaff, Mark W., Snyder, Brian D., Nazarian, Ara, Rodriguez, Edward K.
Format: Article
Language:English
Subjects:
Apoptosis
Atrophy
Autophagy
Care and treatment
Cartilage (articular)
Collagen
Contractures
Cytokines
Diagnosis
Etiology
Fibroblasts
Growth factors
Hypoxia
Injuries
Joint diseases
Joints
Kinases
Mobility
Morbidity
Muscular dystrophy
Musculoskeletal diseases
Nervous system
Neurodegenerative diseases
Neuromuscular
Neuromuscular diseases
Paralysis
Patient outcomes
Physical therapy
Proteins
Range of motion
Review
Risk factors
Spasticity
Spinal cord
Stretching
Surgery
Therapeutics, Physiological
Therapy
Trauma
Tumor necrosis factor-TNF
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Summary:Arthrofibrosis, or rigid contracture of major articular joints, is a significant morbidity of many neurodegenerative disorders. The pathogenesis depends on the mechanism and severity of the precipitating neuromuscular disorder. Most neuromuscular disorders, whether spastic or hypotonic, culminate in decreased joint range of motion. Limited range of motion precipitates a cascade of pathophysiological changes in the muscle-tendon unit, the joint capsule, and the articular cartilage. Resulting joint contractures limit functional mobility, posing both physical and psychosocial burdens to patients, economic burdens on the healthcare system, and lost productivity to society. This article reviews the pathophysiology of arthrofibrosis in the setting of neuromuscular disorders. We describe current non-surgical and surgical interventions for treating arthrofibrosis of commonly affected joints. In addition, we preview several promising modalities under development to ameliorate arthrofibrosis non-surgically and discuss limitations in the field of arthrofibrosis secondary to neuromuscular disorders.
ISSN:1471-2474
1471-2474
DOI:10.1186/s12891-022-05677-z