Collagenase clostridium histolyticum injection versus limited fasciectomy for the treatment of Dupuytren's disease: a systematic review and meta-analysis of comparative studies.

Liechti, Rémy; Merky, Dominique Nellie; Sutter, Damian; Ipaktchi, Ramin; Vögelin, Esther (2024). Collagenase clostridium histolyticum injection versus limited fasciectomy for the treatment of Dupuytren's disease: a systematic review and meta-analysis of comparative studies. Archives of orthopaedic and trauma surgery, 144(1), pp. 527-536. Springer 10.1007/s00402-023-05004-8

[img] Text
s00402-023-05004-8.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB)

INTRODUCTION

The aim of the present study is to systematically review the literature on well-selected comparative studies for meta-analysis on outcome differences between collagenase clostridium histolyticum (CCH) injection and limited fasciectomy (LF) for Dupuytren's disease.

MATERIALS AND METHODS

PubMed/Medline, Embase, and the Cochrane Library were searched for comparative studies assessing differences in outcomes of CCH and LF. Effect estimates were pooled across studies using random effects models and presented as weighted mean difference (MD) and odds ratio (OR) with corresponding 95% confidence interval (CI).

RESULTS

A total of 11 studies encompassing 1'051 patients was included (619 patients in the CCH and 432 in the LF group). The residual contracture at a minimal average follow-up of three months was higher in the CCH group than in the LF group (27.8 vs. 16.2°, MD 11.6°, 95% CI [8.7, 14.5°], p < 0.001). The recurrence rate was significantly higher in the CCH group (25.8 vs. 9.3%, OR 5.2, 95% CI [1.5, 18.8], p = 0.01) while the rate of severe complications was significantly higher in the LF group (0.3 vs. 7.3%, OR 0.12, 95% CI [0.03, 0.42], p = 0.001).

CONCLUSIONS

Evidence of the present study confirms that CCH injection has a higher rate of disease recurrence whereas LF carries a higher risk for severe complications. It's imperative that the trade-off between these aspects is considered, keeping in mind that CCH injections may be repeated in case of disease recurrence without increasing procedure related risks, especially in complex cases.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Plastic, Reconstructive and Aesthetic Surgery

UniBE Contributor:

Liechti, Rémy, Merky, Dominique, Sutter, Damian, Ipaktchi, Ramin, Vögelin, Esther

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1434-3916

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

05 Sep 2023 10:27

Last Modified:

09 Jan 2024 00:13

Publisher DOI:

10.1007/s00402-023-05004-8

PubMed ID:

37665353

Uncontrolled Keywords:

Collagenase injection Dupuytren’s disease Limited fasciectomy Meta-analysis

BORIS DOI:

10.48350/186036

URI:

https://boris.unibe.ch/id/eprint/186036

Actions (login required)

Edit item Edit item
Provide Feedback