Five-Year Results of a Randomized, Controlled Trial of Collagenase Treatment Compared With Needle Fasciotomy for Dupuytren Contracture

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Byström, MartinGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics (författare)

Five-Year Results of a Randomized, Controlled Trial of Collagenase Treatment Compared With Needle Fasciotomy for Dupuytren Contracture

Artikel/kapitelEngelska2022

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Elsevier BV,2022

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LIBRIS-ID:oai:gup.ub.gu.se/313568
https://gup.ub.gu.se/publication/313568URI
https://doi.org/10.1016/j.jhsa.2021.11.019DOI

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Purpose: Over the past decade, collagenase treatment and needle fasciotomy (NF) have gained widespread popularity in the treatment of Dupuytren contracture. This prospective study was designed to compare the results of these treatments in terms of clinical and patient-reported outcomes. Methods: A prospective, randomized, controlled trial included patients with a contracture of 20° or more in a single metacarpophalangeal joint. Patients were allocated to treatment with either NF or collagenase Clostridium histolyticum. The primary outcome was a reduction in the metacarpophalangeal joint contracture to less than 5°. Secondary outcomes included recurrence, the presence of Dupuytren cords, and changes in patient-reported outcomes. The participants were examined 5 years after the intervention. Results: The study cohort comprised 156 patients divided into 2 equally sized groups. After 5 years, data were collected from 143 (92 %) of the initially enrolled participants. The mean time for the clinical follow-up was 5.1 years. In the remaining cohort without a second procedure, 51% (23 patients) in the collagenase Clostridium histolyticum group and 47% (27 patients) in the NF group still had extension deficits of less than 5°. Among the participants with a successful initial procedure, the recurrence rate was 56% (36 patients) in the collagenase Clostridium histolyticum group and 45% (30 patients) in the NF group. There were no differences between the 2 treatments in regard to passive joint extension, reduction of contracture, range of motion, or patient-reported outcomes. Conclusions: The 5-year outcomes for NF are similar to those for collagenase in terms of sustained correction, recurrence, presence of Dupuytren cords, and patient-reported outcomes for the treatment of metacarpophalangeal joint contractures. Type of study/level of evidence: Therapeutic I. © 2021 American Society for Surgery of the Hand

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng
Collagenase
controlled trial
Dupuytren Contracture
fasciotomy
treatment outcome

Biuppslag (personer, institutioner, konferenser, titlar ...)

Ibsen Sörensen, A. (författare)
Samuelsson, Kristian,1977Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics(Swepub:gu)xsakri (författare)
Fridén, Jan,1953Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics(Swepub:gu)xfrija (författare)
Strömberg, JoakimGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics(Swepub:gu)xstjoa (författare)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för ortopedi (creator_code:org_t)

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Ingår i:Journal of Hand Surgery: Elsevier BV47:3, s. 211-2170363-5023

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Av författaren/redakt...: Byström, Martin; Ibsen Sörensen, ...; Samuelsson, Kris ...; Fridén, Jan, 195 ...; Strömberg, Joaki ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Ortopedi

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Av lärosätet: Göteborgs universitet

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