Percutaneous Needle Fasciotomy versus Collagenase Injection for Dupuytren’s Contracture: A Systematic Review of Comparative Studies

Abstract

Introduction The purpose of this study was to review and compare clinical outcomes between percutaneous needle fasciotomy (PNF) and collagenase Clostridium histolyticum (CCH) injection for the treatment of Dupuytren’s contracture.

Materials and Methods A systematic review was performed including all level I-III evidence studies investigating the clinical outcomes of PNF and CCH injection in the treatment of Dupuytren’s contracture.

Results Five studies (278 CCH patients, 225 PNF patients; 285 CCH fingers, 246 PNF fingers, 405 males, and 98 females) were analyzed. Two randomized studies were level I evidence, one randomized study was level II, and two nonrandomized studies were level III. Two studies analyzed a total of 205 patients, each demonstrating statistically superior outcomes in one outcome measure (contracture improvement and Michigan Hand Questionnaire (MHQ) satisfaction subscore) with PNF, while the remaining three studies demonstrated no significant differences in outcomes between the two techniques. Three studies reported a statistically higher rate of minor complications (local pain, edema, ecchymosis, lymphadenopathy, pruritis) with CCH, while the remaining two studies demonstrated no significant difference in complication rates.

Conclusion For the treatment of Dupuytren’s contracture, there is some evidence that suggests superior clinical outcomes of PNF compared with CCH and a higher minor complication rate with CCH.

Keywords

collagenase - Dupuytren’s contracture - percutaneous fasciotomy - contracture

Publication History

Article published online:
31 December 2020

• References

• 1 Lanting R, van den Heuvel ER, Werker PM. Clusters in shortterm disease course in participants with primary Dupuytren disease. J Hand Surg Am 2016; 41 (03) 354-361
• 2 Engstrand C, Krevers B, Nylander G, Kvist J. Hand function and quality of life before and after fasciectomy for Dupuytren contracture. J Hand Surg Am 2014; 39 (07) 1333-1343
• 3 Desai SS, Hentz VR. The treatment of Dupuytren disease. J Hand Surg Am 2011; 36 (05) 936-942
• 4 Denkler K. Surgical complications associated with fasciectomy for dupuytren’s disease: a 20-year review of the English literature. Eplasty 2010; 10: e15
• 5 van Rijssen AL, Werker PM. Percutaneous needle fasciotomy in dupuytren’s disease. J Hand Surg [Br] 2006; 31 (05) 498-501
• 6 Hurst LC, Badalamente MA, Hentz VR. et al. CORD I Study Group. Injectable collagenase clostridium histolyticum for Dupuytren’s contracture. N Engl J Med 2009; 361 (10) 968-979
• 7 van Rijssen AL, ter Linden H, Werker PM. 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
• 8 Mehta S, Belcher HJ. A single-centre cost comparison analysis of collagenase injection versus surgical fasciectomy for Dupuytren’s contracture of the hand. J Plast Reconstr Aesthet Surg 2014; 67 (03) 368-372
• 9 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
• 10 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
• 11 Strömberg J, Ibsen Sörensen A, Fridén J. Percutaneous needle fasciotomy versus collagenase treatment for Dupuytren Contracture: a randomized controlled trial with a two-year follow-up. J Bone Joint Surg Am 2018; 100 (13) 1079-1086
• 12 Zhou C, Hovius SER, Pieters AJ, Slijper HP, Feitz R, Selles RW. Comparative effectiveness of needle aponeurotomy and collagenase injection for Dupuytren’s contracture: a multicenter study. Plast Reconstr Surg Glob Open 2017; 5 (09) e1425
• 13 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
• 14 Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6 (07) 1000097
• 15 Howick J, Chalmers I, Glasziou P, et al. The 2011 Oxford CEBM Evidence Levels of Evidence [Introductory Document]. Oxford Centre for Evidence-Based Medicine. 2011. Available at: http://www.cebm.net/index.aspx?o1⁄45653. Accessed April 20, 2020
• 16 Harris JD, Quatman CE, Manring MM, Siston RA, Flanigan DC. How to write a systematic review. Am J Sports Med 2014; 42 (11) 2761-2768
• 17 Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD. Victorian Institute of Sport Tendon Study Group. Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Scand J Med Sci Sports 2000; 10 (01) 2-11
• 18 Ebell MH, Siwek J, Weiss BD. et al. Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. Am Fam Physician 2004; 69 (03) 548-556
• 19 GRADE Working Group. Grading of Recommendations, Assessment, Development, and Evaluation. 2007. Available at: http://www.gradeworkinggroup.org. Accessed April 5, 2020
• 20 Sterne JAC, Savović J, Page MJ. et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898
• 21 Sterne JAC, Hernán MA, Reeves BC. et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016; 355: i4919
• 22 Selles RW, Zhou C, Kan HJ, Wouters RM, van Nieuwenhoven CA, Hovius SER. Percutaneous aponeurotomy and lipofilling versus limited fasciectomy for Dupuytren’s Contracture: 5-year results from a randomized clinical trial. Plast Reconstr Surg 2018; 142 (06) 1523-1531
• 23 Toppi JT, Trompf L, Smoll NR. et al. Dupuytren’s contracture: an analysis of outcomes of percutaneous needle fasciotomy versus open fasciectomy. ANZ J Surg 2015; 85 (09) 639-643
• 24 Zhou C, Selles RW, Slijper HP. et al. Comparative effectiveness of percutaneous needle aponeurotomy and limited fasciectomy for Dupuytren’s contracture: a multicenter observational. Plast Reconstr Surg 2016; 138 (04) 837-846
• 25 Lauritzson A, Atroshi I. Collagenase injections for Dupuytren’s disease: prospective cohort study assessing 2-year treatment effect durability. BMJ Open 2017; 7 (03) e012943
• 26 Nayar SK, Pfisterer D, Ingari JV. Collagenase Clostridium histolyticum injection for Dupuytren contracture: 2-year follow-up. Clin Orthop Surg 2019; 11 (03) 332-336
• 27 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
• 28 Molenkamp S, Schouten TAM, Broekstra DC, Werker PMN, Moolenburgh JD. Early postoperative results of percutaneous needle fasciotomy in 451 patients with Dupuytren disease. Plast Reconstr Surg 2017; 139 (06) 1415-1421
• 29 van AL Rijssen, Werker PM. Percutaneous needle fasciotomy for recurrent Dupuytren disease. J Hand Surg Am 2012; 37 (09) 1820-1823
• 30 Gilpin D, Coleman S, Hall S, Houston A, Karrasch J, Jones N. Injectable collagenase Clostridium histolyticum: a new nonsurgical treatment for Dupuytren’s disease. J Hand Surg Am 2010; 35 (12) 2027-38.e1
• 31 Beaudreuil J, Lellouche H, Orcel P, Bardin T. Needle aponeurotomy in Dupuytren’s disease. Joint Bone Spine 2012; 79 (01) 13-16
• 32 Hentz VR, Watt AJ, Desai SS, Curtin C. Advances in the management of Dupuytren disease: collagenase. Hand Clin 2012; 28 (04) 551-563
• 33 Spiers JD, Ullah A, Dias JJ. Vascular complication after collagenase injection and manipulation for Dupuytren’s contracture. J Hand Surg Eur Vol 2014; 39 (05) 554-556
• 34 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
• 35 Eberlin KR, Mudgal CS. Complications of treatment for Dupuytren disease. Hand Clin 2018; 34 (03) 387-394
• 36 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
• 37 Atroshi I, Strandberg E, Lauritzson A, Ahlgren E, Waldén M. Costs for collagenase injections compared with fasciectomy in the treatment of Dupuytren’s contracture: a retrospective cohort study. BMJ Open 2014; 4 (01) e004166
• 38 Brazzelli M, Cruickshank M, Tassie E. et al. Collagenase clostridium histolyticum for the treatment of Dupuytren’s contracture: systematic review and economic evaluation. Health Technol Assess 2015; 19 (90) 1-202
• 39 Baltzer H, Binhammer PA. Cost-effectiveness in the management of Dupuytren’s contracture. A Canadian cost-utility analysis of current and future management strategies. Bone Joint J 2013; 95-B [phone]
• 40 Leafblad ND, Wagner E, Wanderman NR. et al. Outcomes and direct costs of needle aponeurotomy, collagenase injection, and fasciectomy in the treatment of Dupuytren Contracture. J Hand Surg Am 2019; 44 (11) 919-927