Recurrent Dupuytren’s disease after fasciectomy and collagenase injection are histologically indistinguishable

2020 ◽  
Vol 45 (5) ◽  
pp. 508-512
Author(s):  
Rafael Sanjuan-Cervero ◽  
Francisco J. Carrera-Hueso ◽  
Manuel Vaquero-Perez ◽  
Daniel Montaner-Alonso
Keyword(s):  
Cohort Study ◽  
Prospective Cohort ◽  
Previous Treatment ◽  
Disease Recurrence ◽  
Dupuytren’S Disease ◽  
Collagenase Clostridium Histolyticum ◽  
Dupuytren's Disease ◽  
Clostridium Histolyticum ◽  
Collagenase Injection ◽  
Previously Treated

The aim of this study was to determine whether recurrent Dupuytren’s disease after collagenase Clostridium histolyticum treatment differs histologically from recurrence in those treated with fasciectomy. We carried out a prospective cohort study of patients with Dupuytren’s disease who underwent fasciectomy to treat disease recurrence after previous treatment with collagenase Clostridium histolyticum or fasciectomy. The pathologists and statistician were blinded to the previous treatment. Longitudinal biopsy sections were stained with haematoxylin-eosin and the nodular zones were examined. Fifteen patients were studied: nine previously treated with collagenase Clostridium histolyticum and six previously treated with fasciectomy. There were no histological differences between the samples from the two groups of patients. Dupuytren’s disease recurrences after fasciectomy and collagenase Clostridium histolyticum are histologically indistinguishable.

Additional Treatment after Collagenase Injections and Needle Fasciotomy for Dupuytren’s Disease: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Denise M. J. Arnold ◽  
Jonathan Lans ◽  
Ritsaart Westenberg ◽  
Kiera Lunn ◽  
Philip Blazar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Additional Treatment ◽  
Dupuytren’S Disease ◽  
Bivariate Analysis ◽  
Dupuytren's Disease ◽  
Bilateral Disease ◽  
Collagenase Injection ◽  
Partial Fasciectomy

Abstract Introduction The aim of this study was to assess the rate of additional treatment after collagenase injection and needle fasciotomy, and what factors are associated with additional procedures for recurrence. Materials and Methods We retrospectively identified 201 adult patients who underwent collagenase injection and 19 patients who underwent needle fasciotomy for Dupuytren’s disease from 2012 to 2014. Outcomes included additional treatment of the same ray for either recurrence or persistence of contracture. To evaluate associated factors, we performed a bivariate analysis. Results Additional treatment after collagenase injection for recurrence was performed in 24% of fingers at a median of 23 months (interquartile range [IQR]: 10.8–36.1) and was associated with bilateral disease (p = 0.008). Additional treatment for persistence was performed in 5.6% at a median of 1.9 months (IQR: 1.1–3.2). Additional treatment for recurrence after needle fasciotomy was performed in 13% of fingers at a median of 28.2 months (IQR: 27.5–28.2) and 4.2% for persistence at 1.1 months. Fingers treated with needle fasciotomy were more likely to undergo secondary open fasciectomy (13% vs. 5.1%, p = 0.022). Conclusion Additional treatment after collagenase injections was performed in 29% of fingers, mostly another collagenase injection, and was associated with bilateral disease. After needle fasciotomy, 17% of patients underwent additional treatment, primarily open partial fasciectomy.

Injectable Collagenase Clostridium Histolyticum: A New Nonsurgical Treatment for Dupuytren's Disease

2010 ◽  
Vol 35 (12) ◽  
pp. 2027-2038.e1 ◽  
Author(s):  
David Gilpin ◽  
Stephen Coleman ◽  
Stephen Hall ◽  
Anthony Houston ◽  
Jeff Karrasch ◽  
...  
Keyword(s):  
Nonsurgical Treatment ◽  
Dupuytren’S Disease ◽  
Collagenase Clostridium Histolyticum ◽  
Dupuytren's Disease ◽  
Clostridium Histolyticum

scholarly journals Examining the Efficacy and Maintenance of Contracture Correction after Collagenase Clostridium Histolyticum Treatment for Dupuytren's Disease

Hand ◽  
2013 ◽  
Vol 8 (3) ◽  
pp. 261-266 ◽  
Author(s):  
Heather A. McMahon ◽  
Abdo Bachoura ◽  
Sidney M. Jacoby ◽  
David S. Zelouf ◽  
Randall W. Culp ◽  
...  
Keyword(s):  
Dupuytren’S Disease ◽  
Collagenase Clostridium Histolyticum ◽  
Dupuytren's Disease ◽  
Clostridium Histolyticum

scholarly journals Hand function 5 years after treatment with collagenase Clostridium histolyticum injection for Dupuytren’s disease

2021 ◽  
pp. 175319342110023
Author(s):  
Ingrid Göransson ◽  
Lars Brudin ◽  
Andra Irbe ◽  
Christina Turesson
Keyword(s):  
Range Of Motion ◽  
Hand Function ◽  
Treatment Method ◽  
Dupuytren’S Disease ◽  
Collagenase Clostridium Histolyticum ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Dupuytren's Disease ◽  
Clostridium Histolyticum ◽  
New Treatment

The aim of this study was to report hand function, disability and satisfaction and patients’ perception of functionally troublesome contractures 5 years after injection with collagenase Clostridium histolyticum and hand therapy for Dupuytren's disease. Data from 79 patients were collected before and at 3, 12 and 60 months after treatment. Hand function was significantly improved, and 70% achieved a functional range of motion in the treated hand. QuickDASH scores and range of motion were best at 3 months follow-up. At 60 months, mean total extension deficit was 48°, which was 57% of the deficit before treatment. Thirty-seven patients (47%) had developed recurrent contractures in treated finger(s) meeting the criteria for new treatment. The threshold for functionally troublesome contractures was found to be 30°–60° in the finger joints. Treatment was experienced as painful, but few hand function problems occurred. Most patients would choose this treatment method again. Level of evidence: IV

Cost Comparison of Collagenase Clostridium Histolyticum and Fasciectomy for Treatment of Dupuytren’s Contracture in the Australian Health System

2018 ◽  
Vol 23 (03) ◽  
pp. 336-341 ◽  
Author(s):  
Andrew K. Sefton ◽  
Belinda J. Smith ◽  
David A. Stewart
Keyword(s):  
Treatment Options ◽  
Cost Comparison ◽  
Dupuytren’S Disease ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Health Care Environment ◽  
Dupuytren's Disease ◽  
Australian Health ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum

Background: Dupuytren’s disease results in contracted cords in the hand that lead to deformity and disability. Current treatment options include fasciectomy and an injectable, collagenase clostridium histolyticum. No cost comparison studies have been published within the Australian health care environment. Methods: A retrospective review of all patients treated for Dupuytren’s disease in a major teaching hospital was undertaken to compare the costs of treatment by fasciectomy or collagenase injection. Results: Eighteen patients underwent fasciectomy and 21 collagenase clostridium histolyticum injections were performed during the study period and were eligible for inclusion under the review criteria. Of the 39 patients, 36 were male and 3 were female with an average age 66.4 years (50–85). Twenty-five digits were treated by fasciectomy in 18 patients, and 23 digits were treated by collagenase in 21 patients. The fasciectomy group attended an average 9.2 visits (5–22), incurring an average costing of US$5738.12 per patient ($3181.18–$9618.10). The collagenase group attended an average 3.8 visits (3–8), incurring an average costing of US$2076.83 per patient ($1842.24–$3929.57). Conclusions: Collagenase treatment of Dupuytren’s contracture represents a significant reduction in cost relative to fasciectomy, with 64% savings, length of follow up and number of visits. This is a similar finding to studies in other countries.

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