A
contracture is a joint abnormally bent by shortened
soft tissues in and around the joint. The shortened tissues pull the bone out
of normal position. A contracture may develop in a joint affected by
juvenile rheumatoid arthritis (JRA). Because of the
effectiveness of today's treatments, your child probably will not develop
contractures. However, if a contracture does develop, treatment may include
splints and physical therapy.
Surgery is rarely used to treat JRA. However, it is sometimes used to
release contractures of at least moderate severity that have not responded to
other treatments. Surgery is sometimes necessary to restore motion, especially
for hip and knee contractures that interfere with walking.
One procedure used is soft tissue releases of contractures, which
involves cutting the muscles attached to an abnormally bent joint. As the
muscles and other shortened tissues are released, the affected joint can return
to a more normal position.
Goals of soft tissue releases of contractures include:
- Returning the joint to a more functional
position.
- Increasing range of motion.
- Relieving
pain.
Casts are usually used for several weeks after contracture releases
of the knee, followed by physical therapy and nighttime splinting. This
procedure often relieves the contracture and pain associated with it and makes
it easier for the child to move the joint.
Physical therapy after a soft tissue release is essential to
maintaining benefit from the procedure. For this reason, children must be at
least 6 years old to be considered for this surgery.