Collagenase Injection vs Percutaneous Needle Aponeurotomy for Dupuytren's Disease
Dupuytren Contracture, Dupuytren's Disease of Finger
About this trial
This is an interventional treatment trial for Dupuytren Contracture focused on measuring Collagenase injection, percutaneous needle aponeurotomy
Eligibility Criteria
Inclusion Criteria:
- Patients requiring treatment for functionally limiting Dupuytren's disease involving the MCP and PIP joints, defined as MCP joint contracture 20-100 degrees, PIP joint contracture 20-80 degrees and positive table top test. Patients must be over 18 years of age to enroll in the study.
Exclusion Criteria:
- Patients who have had previous interventions of contracture presenting for treatment, in an effort to compare similar disease state and risk with each procedure.
- Disease involving DIP joint or thumb, as collagenase has not been approved for use in the thumb or DIP joints.
- Pregnant or nursing, although there is data indicating no detection of collagenase in patient serum following injection for Dupuytren's contractures, there is no data exploring the effects of collagenase on a fetus or infant.
- Anticoagulation therapy other than ASA (held 7 days prior to procedure), which is a recommendation by the manufacture of collagenase used in this study.
Sites / Locations
- University of CalgaryRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Percutaneous Needle Aponeurotomy
Collagenase Injection
Percutaneous Needle Aponeurotomy (PNA) involves the surgeon anaesthetizing the skin over the Dupuytren's cord, then using a small gauge needle inserted percutaneously, cutting the cord with the sharp edge of the needle using a sweeping motion. This is repeated up the length of the cord to weaken it, allowing an extension force to be applied over the finger to rupture the cord.
Collagenase Injection (CI) involves the injection of collagenase clostridium histolyticum (0.58 mg), directly into the Dupuytren's cord. The patient then returns to see the surgeon within one week, has local anaesthetic is administered, and an extension force is applied to the affected digit to rupture the already weakened cord.