Three-Year Recurrence of Dupuytren Contracture after Needle Fasciotomy or Collagenase Injection: A Randomized Controlled Trial

Plast Reconstr Surg. 2023 Feb 1;151(2):365-371. doi: 10.1097/PRS.0000000000009847. Epub 2022 Nov 9.

Abstract

Background: In this randomized controlled trial, the authors compared the recurrence of Dupuytren disease at 3 years following needle fasciotomy or collagenase injection treatment for isolated metacarpophalangeal joint contractures.

Methods: The study was conducted between 2013 and 2015. The study design was a single-center, randomized controlled clinical trial with an independent blinded observer. Patients were randomized between collagenase clostridium histolyticum injections (Xiapex) and percutaneous needle fasciotomy (collagenase clostridium histolyticum versus percutaneous needle fasciotomy). A total of 36 patients were followed in the percutaneous needle fasciotomy group and 32 in the collagenase clostridium histolyticum group.

Results: Patients who were treated with collagenase clostridium histolyticum had a significantly lower recurrence rate than patients treated with percutaneous needle fasciotomy during the 3-year period ( P = 0.007). Of the 36 patients who were followed in the percutaneous needle fasciotomy group, 17 (47%) had recurrence of extension deficit or progression of the disease leading to further treatment. Of the 32 patients who were followed in the collagenase clostridium histolyticum group, six (19%) had recurrence or progression. No serious adverse event was reported in any of the patients.

Conclusions: In this randomized controlled trial, we found less recurrence and progression of Dupuytren disease using collagenase injection as compared to percutaneous needle fasciotomy 3 years following treatment for isolated metacarpophalangeal joint contractures.

Clinical question/level of evidence: Therapeutic, I.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Collagenases / therapeutic use
  • Dupuytren Contracture* / drug therapy
  • Dupuytren Contracture* / surgery
  • Fasciotomy
  • Follow-Up Studies
  • Humans
  • Injections, Intralesional
  • Microbial Collagenase / therapeutic use
  • Recurrence
  • Treatment Outcome

Substances

  • Microbial Collagenase
  • Collagenases