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DOS Kongressen 2017 ·
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XIAPEX® is a viable first-line treatment of MCP
Dupuytrens contractures, however inferior in PIP
joints. 1 to 4 year follow-up of 178 joints
Charlotte Hartig-Andreasen, Lena Schroll, Jeppe Lange
Orthopaedic surgery, Regionshospitalet Horsens
Background:
The optimal minimal invasive treatment for Dupuytren contrac-
tures remains debated. Xiapex is a treatment introduced into the commercial
marked since its approval in 2009. When introducing new efficacious modalities
into everyday practice the effectiveness of these must be properly evaluated.
Purpose / Aim of Study:
The aim of this study was to evaluate the effect of
xiapex treatment at Regionshospitalet Horsens after minimum one-year follow-
up (FU).
Materials and Methods:
118 MCP joints and 60 PIP joints treated from Jan
2013 to May 2016 were available for follow-up. Mean FU were 2.5 years
(95%CI 2.4-2.6). Mean age at treatment was 68 years (95%CI 67-69). 82%
was male. 37 had received treatment in the affected joint prior to our XIAPEX,
21 percutaneous needle fascioctomi, 12 open surgery and 4 XIAPEX. XIAPEX®
treatment was performed according to manufactures guidelines. Outcomes
were 1) absolute change in extension deficit (ED) in degrees from baseline to
follow-up in metacarpo phalangeal (MCP) and proximal interphalangeal (PIP)
joints 2) contraction recurrence defined as ED above 20degrees, 3)Hurst end-
point defined as ED below 5 degrees .
Findings / Results:
Baseline mean ED 49° (range 20° -90°) for MCP and
56° (range 20°-90°) for PIP. Immediately after cord rupture the mean ED 0°
(range 0°-10°) for MCP and 8° (range 0°-80°) for PIP. The absolute change
in ED was 48° (95%CI 46-51) for MCP and 47° (95%CI 42-52) for PIP. Con-
traction recurrence rate was 89% (95%CI 83-95) for MCP and 22%(95%CI
11-32) for PIP. Hurst endpoint was reach in 74% (95%CI 66-82) for MCP and
5% (95%CI 0-11) for PIP. 91% of the evaluated patients were willing to have
XIAPEX treatment again if necessary. No safety aspects were detected at FU.
Conclusions:
XIAPEX® is a viable first-line treatment of MCP Dupuytrens con-
tractures, however inferior in PIP joints.
No conflicts of interest reported
161.