Dupuytren's Contracture. The Safety and Efficacy of Collagenase Treatment.

BACKGROUND: Our main goal was to see if treatment with collagenase injection is safe and effective and to assess patient satisfaction with this new treatment.

METHODS: We prospectively followed 77 consecutive patients, treated for contracture in 91 fingers and 142 joints that received total of 109 collagenase injections. The patients were reviewed on the first and second day and at 4 and 12 months. A contracture reduced to five degrees or less at 12 months after the last injection, was considered to be a successful outcome.

RESULTS: A mean of 1.2 injections were used per patient and 0.8 injections per joint. There was a significant improvement in mean passive extension deficit. Out of the 142 joints treated, 84 (59%) met our criterion for a successful outcome; 56 (80%) out of 70 MCP joints and 28 (39%) out of 72 PIP joints. There were also significant improvements in both hand function and pain. No serious adverse events were observed. The mean patient satisfaction with the treatment at the 12-month follow up was a VAS score of 78 (0 = none; 100 = complete) and only 11% stated that they would not have consented to the treatment if they had known the outcome in advance.

CONCLUSIONS: Treatment of Dupuytren's disease with collagenase injection is both safe and effective. It is now our primary treatment for Dupuytren's disease.