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Factors predicting the 1-year outcome of collagenase treatment for Dupuytren’s disease

  • Anne-Gita Scheibler
  • Miriam Marks
  • Stefanie Hensler
  • Daniel B. HerrenEmail author
  • Maurizio Calcagni
Handsurgery
  • 16 Downloads

Abstract

Introduction

Several studies have investigated the clinical outcome after collagenase treatment for Dupuytren’s disease in terms of range of motion of the affected finger. However, good objective clinical outcome defined by a small remaining flexion contracture does not necessarily translate into satisfactory patient-subjective hand function. The aim of the present study was to identify predictors of patient-reported as well as objective clinical outcome in patients 1 year after collagenase treatment for Dupuytren’s disease.

Materials and methods

Socio-demographic and disease-related data of 92 Dupuytren patients were collected prior to the intervention. Flexion contracture of the most affected finger was measured at baseline and 1 year after treatment. Patients also completed the brief Michigan Hand Outcomes Questionnaire (brief MHQ) before the intervention and at 1-year follow-up. First, univariate correlations using Pearson’s correlation coefficient of the baseline variables with the two target variables were investigated. All variables with r > 0.35 were selected for a multivariate linear stepwise backwards regression model.

Results

The mean brief MHQ score increased between baseline (72 ± 14) and the 1-year follow-up (85 ± 15) (p ≤ 0.001) and baseline flexion contracture decreased from 76° (± 26) to 33° (± 31) (p ≤ 0.001). Higher hand function at baseline (R2 = 0.31) and less flexion contracture (R2 = 0.46) were identified as positive predictors for the outcome 1 year after collagenase treatment for Dupuytren’s disease. Other variables such as age, gender, manual work and if the MCP or PIP joint was affected did not determine outcome in our patient series.

Conclusions

Collagenase treatment resulted in considerable improvement in flexion contracture as well as patient-reported hand function at the 1-year follow-up. Clinicians can expect better outcome after collagenase infiltration in patients with less flexion contracture and in patients showing good initial self-reported hand function.

Keywords

Dupuytren’s disease Collagenase Clostridium histolyticum Outcome Predictive factor 

Notes

Acknowledgements

We would like to thank Martina Wehrli for her assistance during data collection and Dr Melissa Wilhelmi for manuscript editing.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

M. Calcagni has received sponsoring from SOBI for an event on Dupuytren treatment. All other authors have no conflict of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Patient informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Anne-Gita Scheibler
    • 1
  • Miriam Marks
    • 2
  • Stefanie Hensler
    • 2
  • Daniel B. Herren
    • 1
    Email author
  • Maurizio Calcagni
    • 3
  1. 1.Department of Hand SurgerySchulthess KlinikZurichSwitzerland
  2. 2.Department of Teaching, Research and DevelopmentSchulthess KlinikZurichSwitzerland
  3. 3.Department of Plastic and Hand SurgeryUniversity Hospital ZurichZurichSwitzerland

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