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

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.

Keywords

collagenase - clostridium histolyticum - xiaflex - needle fasciotomy - aponeurotomy - dupuytren - contracture

Publikationsverlauf

Artikel online veröffentlicht:
26. Juli 2020

• References

• 1 Dibenedetti DB, Nguyen D, Zografos L, Ziemiecki R, Zhou X. Prevalence, incidence, and treatments of Dupuytren’s disease in the United States: results from a population-based study. Hand (N Y) 2011; 6 (02) 149-158
• 2 Ng M, Thakkar D, Southam L. et al A Genome-wide association study of Dupuytren disease reveals 17 additional variants implicated in fibrosis. Am J Hum Genet 2017; 101 (03) 417-427
• 3 Eaton C. Evidence-based medicine: Dupuytren contracture. Plast Reconstr Surg 2014; 133 (05) 1241-1251
• 4 Eaton C. The next stage of clinical Dupuytren Research: biomarkers and chronic disease research tools. Dupuytren Dis Relat Dis Cut Edge 2017; 51: 391-407
• 5 Peimer CA, Blazar P, Coleman S, Kaplan FTD, Smith T, Lindau T. Dupuytren Contracture Recurrence Following Treatment With Collagenase Clostridium histolyticum (CORDLESS [Collagenase Option for Reduction of Dupuytren Long-Term Evaluation of Safety Study]): 5-Year Data. J Hand Surg Am 2015; 40 (08) 1597-1605
• 6 Zhao JZ, Hadley S, Floyd E, Earp BE, Blazar PE. The Impact of collagenase clostridium histolyticum introduction on Dupuytren treatment patterns in the United States. J Hand Surg Am 2016; 41 (10) 963-968
• 7 Hermiz SJ, Kalliainen LK. Evidence-based medicine: current evidence in the diagnosis and management of carpal tunnel syndrome. Plast Reconstr Surg 2017; 140 (01) 120e-129e
• 8 Auld T, Werntz JR. Dupuytren’s disease: how to recognize its early signs. J Fam Pract 2017; 66 (03) E5-E10
• 9 Ketchum LD. The rationale for treating the nodule in Dupuytren’s disease. Plast Reconstr Surg Glob Open 2015; 2 (12) e278
• 10 Badalamente MA, Hurst LC, Benhaim P, Cohen BM. Efficacy and safety of collagenase clostridium histolyticum in the treatment of proximal interphalangeal joints in dupuytren contracture: combined analysis of 4 phase 3 clinical trials. J Hand Surg Am 2015; 40 (05) 975-983
• 11 Skov ST, Bisgaard T, Søndergaard P, Lange J. Injectable collagenase versus percutaneous needle fasciotomy for Dupuytren contracture in proximal interphalangeal joints: a randomized controlled trial. J Hand Surg Am 2017; 42 (05) 321-328
• 12 Henry M. Dupuytren’s disease: current state of the art. Hand (N Y) 2014; 9 (01) 1-8
• 13 van Rijssen AL, ter Linden H, Werker PMN. Five-year results of a randomized clinical trial on treatment in Dupuytren’s disease: percutaneous needle fasciotomy versus limited fasciectomy. Plast Reconstr Surg 2012; 129 (02) 469-477
• 14 Foucher G, Medina J, Navarro R. G. F. [Percutaneous needle aponeurotomy. Complications and results]. Chir Main 2001; 20 (03) 206-211
• 15 Pess GM, Pess RM, Pess RA. Results of needle aponeurotomy for Dupuytren contracture in over 1,000 fingers. J Hand Surg Am 2012; 37 (04) 651-656
• 16 Strömberg J, Ibsen-Sörensen A, Fridén J. Comparison of treatment outcome after collagenase and needle fasciotomy for Dupuytren contracture: a randomized, single-blinded, clinical trial with a 1-year follow-up. J Hand Surg Am 2016; 41 (09) 873-880
• 17 Nydick JA, Olliff BW, Garcia MJ, Hess AV, Stone JD. A comparison of percutaneous needle fasciotomy and collagenase injection for dupuytren disease. J Hand Surg Am 2013; 38 (12) 2377-2380
• 18 Peimer CA, Blazar P, Coleman S. et al Dupuytren contracture recurrence following treatment with collagenase clostridium histolyticum (CORDLESS study): 3-year data. J Hand Surg Am 2013; 38 (01) 12-22
• 19 Gaston RG, Larsen SE, Pess GM. et al The efficacy and safety of concurrent collagenase clostridium histolyticum injections for 2 dupuytren contractures in the same hand: A prospective, multicenter study. J Hand Surg Am 2015; 40 (10) 1963-1971
• 20 Warwick D, Arner M, Pajardi G. et al POINT X Investigators. Collagenase clostridium histolyticum in patients with Dupuytren’s contracture: results from POINT X, an open-label study of clinical and patient-reported outcomes. J Hand Surg Eur Vol 2015; 40 (02) 124-132
• 21 Scherman P, Jenmalm P, Dahlin LB. One-year results of needle fasciotomy and collagenase injection in treatment of Dupuytren’s contracture: a two-centre prospective randomized clinical trial. J Hand Surg Eur Vol 2016; 41 (06) 577-582
• 22 Kan HJ, Verrijp FW, Hovius SER, van Nieuwenhoven CA, Selles RW. Dupuytren Delphi Group. Recurrence of Dupuytren’s contracture: a consensus-based definition. PLoS One 2017; 12 (05) e0164849
• 23 Townley WA, Baker R, Sheppard N, Grobbelaar AO. Dupuytren’s contracture unfolded. BMJ 2006; 332 (75/38) 397-400
• 24 Bayat A, McGrouther DA. Management of Dupuytren’s disease–clear advice for an elusive condition. Ann R Coll Surg Engl 2006; 88 (01) 3-8
• 25 Chen NC, Shauver MJ, Chung KC. Cost-effectiveness of open partial fasciectomy, needle aponeurotomy, and collagenase injection for dupuytren contracture. J Hand Surg Am 2011; 36 (11) 1826-1834
• 26 Centers for Medicare and Medicaid Services. Physician Administered Drug Fee Schedule Effective 01/01/2020. Available at: https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/2020-asp-drug-pricing-files. Accessed June 8, 2020
• 27 Centers for Medicare and Medicaid Services. Physician Fee Schedule Effective 01/01/2020. Available at: https://www.cms.gov/apps/physician-fee-schedule. Accessed June 8, 2020