Published online Apr 18, 2024. doi: 10.5312/wjo.v15.i4.355
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
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.
To compare the short-term (12 wk) and long-term (10 years) outcomes on CCH treatment in patients with DC.
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.
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.
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.
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.