Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2024; 15(4): 355-362
Published online Apr 18, 2024. doi: 10.5312/wjo.v15.i4.355
Long-term assessment of collagenase treatment for Dupuytren’s contracture: A 10-year follow-up study
Marco Passiatore, Vitale Cilli, Adriano Cannella, Ludovico Caruso, Giulia Maria Sassara, Giuseppe Taccardo, Rocco De Vitis
Marco Passiatore, Department of Bone and Joint Surgery, ASST-Spedali Civili, Brescia 25123, Italy
Vitale Cilli, Department of Chirurgie de la Main, Centre Hospitalier Interregional Edith Cavell, Bruxelles 1160, Belgium
Adriano Cannella, Ludovico Caruso, Giulia Maria Sassara, Giuseppe Taccardo, Rocco De Vitis, Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome 00168, Italy
Author contributions: Passiatore M wrote the manuscript; Cilli V, Cannella A, Caruso L, and Sassara GM participated in acquisition, analysis, and interpretation of the data; Taccardo G was the guarantor, designed the study, and performed the surgical treatments; De Vitis R designed the study and performed the surgical treatments; Taccardo G and De Vitis R critically revised the article for important intellectual content; All authors read and approved the final manuscript.
Institutional review board statement: This prospective study was approved by the local ethics committee (Ethics Committee Protocol P/488-857-872-1041-1113/CE/2012).
Clinical trial registration statement: This study is registered at ClinicalTrial.Gov. The registration identification number is NCT01229436.
Informed consent statement: The authors declare that all patients signed the informed consent.
Conflict-of-interest statement: The authors declare that are no conflicts of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rocco De Vitis, MD, Additional Professor, Surgeon, Department of Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Unità Operativa Complessa di Chirurgia della mano, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, Roma 00168, Italy. roccodevitis@yahoo.com
Received: December 31, 2023
Peer-review started: December 31, 2023
First decision: January 16, 2024
Revised: January 30, 2024
Accepted: March 18, 2024
Article in press: March 18, 2024
Published online: April 18, 2024
Processing time: 107 Days and 8 Hours
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.

Keywords: Collagenase; Xiapex; Dupuytren disease; Dupuytren recurrence; Long term follow-up

Core Tip: Collagenase has shown efficacy in the treatment of Dupuytren’s contracture (DC). While its short-term effectiveness is well-documented in the existing literature, there is an absence of studies addressing the long-term outcomes of collagenase treatment of DC. The objectives of this study were to compare the short-term and long-term (10 years) outcomes and to assess the satisfaction with the treatment in 45 subjects enrolled in a phase 3 study in 2012.