학술논문
Long-term assessment of collagenase treatment for Dupuytren's contracture: A 10-year follow-up study.
Document Type
Academic Journal
Author
Passiatore M; Department of Bone and Joint Surgery, ASST-Spedali Civili, Brescia 25123, Italy.; Cilli V; Department of Chirurgie de la Main, Centre Hospitalier Interregional Edith Cavell, Bruxelles 1160, Belgium.; Cannella A; Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy.; Caruso L; Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy.; Sassara GM; Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy.; Taccardo G; Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy.; De Vitis R; Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy. roccodevitis@yahoo.com.
Source
Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101576349 Publication Model: eCollection Cited Medium: Print ISSN: 2218-5836 (Print) Linking ISSN: 22185836 NLM ISO Abbreviation: World J Orthop Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2218-5836
Abstract
Background: Enzymatic fasciotomy with collagenase clostridium histolyticum (CCH) has revolutionized the treatment for Dupuytren's contracture (DC). Despite its benefits, the long-term outcomes remain unclear. This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.
Aim: To compare the short-term (12 wk) and long-term (10 years) outcomes on CCH treatment in patients with DC.
Methods: A cohort of 45 patients was treated with CCH at the metacarpophalangeal (MCP) joint and the proximal interphalangeal (PIP) joint and underwent systematic re-evaluation. The study adhered to multicenter trial protocols, and assessments were conducted at 12 wk, 7 years, and 10 years post-surgery.
Results: Thirty-seven patients completed the 10-year follow-up. At 10 years, patients treated at the PIP joint exhibited a 100% recurrence. However, patients treated at the MCP joint only showed a 50% recurrence. Patient satisfaction varied, with a lower satisfaction reported in PIP joint cases. Recurrence exceeding 20 degrees on the total passive extension deficit was observed, indicating a challenge for sustained efficacy. Significant differences were noted between outcomes at the 7-year and 10-year intervals.
Conclusion: CCH demonstrated sustained efficacy when applied to the MCP joint. However, caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction. Re-intervention is needed within a decade of treatment.
Competing Interests: Conflict-of-interest statement: The authors declare that are no conflicts of interest.
(©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Aim: To compare the short-term (12 wk) and long-term (10 years) outcomes on CCH treatment in patients with DC.
Methods: A cohort of 45 patients was treated with CCH at the metacarpophalangeal (MCP) joint and the proximal interphalangeal (PIP) joint and underwent systematic re-evaluation. The study adhered to multicenter trial protocols, and assessments were conducted at 12 wk, 7 years, and 10 years post-surgery.
Results: Thirty-seven patients completed the 10-year follow-up. At 10 years, patients treated at the PIP joint exhibited a 100% recurrence. However, patients treated at the MCP joint only showed a 50% recurrence. Patient satisfaction varied, with a lower satisfaction reported in PIP joint cases. Recurrence exceeding 20 degrees on the total passive extension deficit was observed, indicating a challenge for sustained efficacy. Significant differences were noted between outcomes at the 7-year and 10-year intervals.
Conclusion: CCH demonstrated sustained efficacy when applied to the MCP joint. However, caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction. Re-intervention is needed within a decade of treatment.
Competing Interests: Conflict-of-interest statement: The authors declare that are no conflicts of interest.
(©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)