PMID- 33478271 OWN - NLM STAT- MEDLINE DCOM- 20220831 LR - 20230902 IS - 1558-9455 (Electronic) IS - 1558-9447 (Print) IS - 1558-9447 (Linking) VI - 17 IP - 5 DP - 2022 Sep TI - Treatment of Dupuytren's Contracture With Collagenase: A Systematic Review. PG - 815-824 LID - 10.1177/1558944720974119 [doi] AB - This systematic review investigates complications and recurrence of Dupuytren's contracture in metacarpophalangeal joints (MCPJs) and/or proximal interphalangeal joints (PIPJs) of fingers treated with collagenase clostridium histolyticum (CCH). A review of the literature on Dupuytren's disease was performed using PRISMA guidelines. Included publications described complications and/or recurrences for contractures >/=20 degrees in MCPJs and/or PIPJs treated with CCH. Successful treatments reduced contractures to /=20 degrees in a successfully treated finger in patients with >/=12 months of follow-up. Of 2675 patients (3753 joints), 94% experienced >/=1 treatment-related AE, most commonly peripheral edema (64%), pain in extremity (53%), and contusion (51%). Major surgical complications occurred in 9 patients (1.0%). Major nonsurgical complications occurred in 2 patients, specifically nonrupture tendon injury and anaphylaxis. Of 1488 patients (2069 joints), recurrences were reported in 23% of successfully treated joints (n = 466; 20% MCPJs, 28% PIPJs), on average 12 to 24 months after treatment. MCPJs achieved greater success than PIPJs in initial contracture reduction (77% versus 36%). CCH is a safe, effective treatment to improve hand function in Dupuytren's contracture. Most AEs are minor and self-resolving, although the risk of major AEs still exists. Following treatment, 23% of successfully treated joints experience recurrence, typically within 12 to 24 months but sometimes as early as 6 months. Surgeons are encouraged to discuss these risks with patients for shared decision-making regarding optimal treatment modalities. FAU - Sandler, Alexis B AU - Sandler AB AUID- ORCID: 0000-0002-5784-9473 AD - The George Washington University, Washington, DC, USA. FAU - Scanaliato, John P AU - Scanaliato JP AD - William Beaumont Army Medical Center, El Paso, TX, USA. FAU - Dennis, Thomas AU - Dennis T AD - Annapolis Hand Center, Annapolis, MD, USA. FAU - Gonzalez Trevizo, Gilberto A AU - Gonzalez Trevizo GA AD - Texas Tech University Health Sciences Center, El Paso, TX, USA. FAU - Raiciulescu, Sorana AU - Raiciulescu S AD - Uniformed Services University of the Health Sciences, Bethesda, MD, USA. FAU - Nesti, Leon AU - Nesti L AD - Uniformed Services University of the Health Sciences, Bethesda, MD, USA. FAU - Dunn, John C AU - Dunn JC AUID- ORCID: 0000-0002-2292-8227 AD - William Beaumont Army Medical Center, El Paso, TX, USA. LA - eng PT - Journal Article PT - Systematic Review DEP - 20210121 PL - United States TA - Hand (N Y) JT - Hand (New York, N.Y.) JID - 101264149 RN - EC 3.4.24.- (Collagenases) RN - EC 3.4.24.3 (Microbial Collagenase) SB - IM MH - Collagenases/therapeutic use MH - *Dupuytren Contracture/drug therapy MH - Humans MH - Injections, Intralesional MH - Microbial Collagenase/therapeutic use MH - Recurrence PMC - PMC9465774 OTO - NOTNLM OT - CCH OT - Dupuytren OT - anatomy OT - collagenase OT - contracture OT - hand COIS- Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2021/01/23 06:00 MHDA- 2022/09/01 06:00 PMCR- 2023/09/01 CRDT- 2021/01/22 05:43 PHST- 2021/01/23 06:00 [pubmed] PHST- 2022/09/01 06:00 [medline] PHST- 2021/01/22 05:43 [entrez] PHST- 2023/09/01 00:00 [pmc-release] AID - 10.1177_1558944720974119 [pii] AID - 10.1177/1558944720974119 [doi] PST - ppublish SO - Hand (N Y). 2022 Sep;17(5):815-824. doi: 10.1177/1558944720974119. Epub 2021 Jan 21.