Factors influencing recurrence and progression of Dupuytren’s disease treated by Collagenase Clostridium histolitycum

• DOI: 10.1007/s00264-017-3690-0
• Publication Date: 2017-11-23T10:19:50Z
• Authors: Clarisa Simón-Pérez; Julian Alía-Ortega; Belen García-Medrano; Jose Ignacio Rodr...; Maria Brotat-Rodr...; Hector Aguado-Her...; Miguel Angel Mart...
• Keywords: Male; Middle Aged; 3. Good health; Dupuytren Contracture; 03 medical and health sciences; Microbial Collagenase; Postoperative Complications; Treatment Outcome; 0302 clinical medicine; Patient Satisfaction; Recurrence; Risk Factors; Disease Progression; Humans; Female; Orthopedic Procedures; Prospective Studies; Aged; Follow-Up Studies

The purpose of this study was to determine the recurrence rate, possible adverse reactions and factors influencing recurrence and progression of Dupuytren's disease (DD) treated with Collagenase from Clostridium histolyticum (CCH).This was a prospective study of 71 patients with DD treated with CCH from 2011 to February 2013, with a minimum follow-up period of four years. Clinical, functional, patient satisfaction, drug safety and factors influencing recurrence and disease progression were evaluated.In all patients, the rupture of the cord was achieved after the injection, reducing joint contracture. In five patients (7%) we verified the existence of disease recurrence during the follow-up. In 11 patients (15.5%) there was a disease progression. Three patients have been surgically operated on, without added surgery difficulty; the rate of recurrence and progression was higher in grades III and IV of Tubiana, in proximal interphalangeal (PIP) punctures, and was earlier in patients younger than 60 years.No serious local complications or general complications were observed with this method. The recurrence of DD, following criteria of Felici, is mainly observed in young patients with greater severity of the disease and at the PIP level. Progression is influenced by the same factors. Patients operated on after recurrence have no added difficulty in the surgical technique, as it has also been published in other studies.Patients with the lowest rates of recurrence and progression were those with a single cord in the metacarpophalangeal (MCP), a grade II of Tubiana, and were older than 60 years.