Treatment Durability of Limited Fasciectomy versus Percutaneous Needle Fasciotomy for Dupuytren Disease.

Background: Patients with Dupuytren disease (DD) are mostly surgically treated by percutaneous needle fasciotomy (PNF) or limited fasciectomy (LF), but data on time intervals to retreatment are lacking. The authors aimed to estimate the risk of retreatment within certain time periods after treatment with PNF and LF.

Methods: The authors used data of participants of a cohort study on the course of DD who were treated only with PNF or LF. The primary outcome measure was time to retreatment of DD. The authors included sex, age at first treatment, and having a first-degree relative with DD as confounders in our analysis. A bivariate gamma frailty model was applied to estimate the risk of retreatment within 1, 3, 5, 10, and 20 years after treatment with PNF and LF.

Results: The time to retreatment was significantly shorter after treatment with PNF than after LF (Wald test statistic, 7.56; P < 0.001). The estimated 10-year risk of retreatment for men who underwent their first treatment at a younger age and with a first-degree relative with DD was 97% after PNF and 32% after LF. The estimated 10-year risk for women who underwent their first treatment at an older age without a first-degree relative with DD was 20% after PNF and 6% after LF.

Conclusions: The results show that the patients treated with PNF have a higher risk of retreatment. The results of this study could contribute to individualized information on the treatment durability in the future, which would improve patient counseling about the expected retreatment needs.

Clinical question/level of evidence: Therapeutic, III.