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What are the latest advances in Dupuytrens Contracture?

Here you can see the latest advances and discoveries made regarding Dupuytrens Contracture.

Latest progress of Dupuytrens Contracture

Dupuytren's contracture is a condition that affects the hand, specifically the fingers, causing them to bend inward towards the palm. It is a progressive disease that can lead to functional limitations and decreased quality of life for those affected. Over the years, there have been several advances in the treatment of Dupuytren's contracture, aimed at improving outcomes and reducing the need for invasive procedures.



1. Non-Surgical Treatment Options:


Traditionally, surgery has been the mainstay of treatment for Dupuytren's contracture. However, recent advances have introduced non-surgical options that can effectively manage the condition. One such treatment is collagenase injection therapy. This involves injecting an enzyme called collagenase into the affected tissue, which helps break down the excess collagen responsible for the contracture. Collagenase injection therapy has shown promising results in reducing contracture and improving hand function.



2. Minimally Invasive Procedures:


In addition to non-surgical options, there have been significant advancements in minimally invasive procedures for Dupuytren's contracture. These procedures involve making small incisions or using percutaneous techniques to release the contracted tissue. One such procedure is percutaneous needle fasciotomy, where a needle is inserted into the affected tissue to divide the contracted bands. Another minimally invasive technique is percutaneous aponeurotomy with lipografting, which combines the release of contracted tissue with the injection of fat cells to improve outcomes.



3. Radiotherapy:


Radiotherapy has emerged as a potential treatment option for Dupuytren's contracture. Low-dose radiation is delivered to the affected hand, targeting the abnormal tissue and inhibiting its growth. This approach has shown promising results in reducing contracture progression and improving hand function. However, further research is needed to establish its long-term efficacy and safety.



4. Regenerative Medicine:


Advancements in regenerative medicine hold promise for the treatment of Dupuytren's contracture. Stem cell therapy and tissue engineering techniques are being explored to regenerate healthy tissue and replace the fibrotic tissue responsible for the contracture. While still in the experimental stages, these approaches have the potential to revolutionize the treatment of Dupuytren's contracture by promoting tissue regeneration and preventing recurrence.



5. Improved Imaging Techniques:


Accurate diagnosis and assessment of Dupuytren's contracture are crucial for determining the most appropriate treatment approach. Recent advances in imaging techniques, such as ultrasound and magnetic resonance imaging (MRI), have improved the visualization of the affected tissue. These imaging modalities allow for better preoperative planning and monitoring of disease progression, leading to more targeted and effective treatment strategies.



In conclusion, there have been significant advances in the treatment of Dupuytren's contracture, ranging from non-surgical options to minimally invasive procedures, radiotherapy, regenerative medicine, and improved imaging techniques. These advancements offer hope for improved outcomes, reduced invasiveness, and enhanced quality of life for individuals affected by this condition.


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Newer advances in Dupuytren’s disease

There is ongoing research into the genetics of Dupuytren’s disease, which has improved the understanding of the condition. A positive association of HLA-DRB1*15 with Dupuytren's disease in Caucasians has been described.23 An increase in expression of the TGF β-2 gene has been demonstrated in cords from Dupuytren’s tissue.24 Several biomarkers have also been identified in Dupuytren’s tissue which may have implications in future diagnostics and treatments.25

A further recent and significant advance in the treatment of Dupuytren’s disease has been the development of enzymatic fasciectomy with clostridial collagenase. Hurst et al performed a prospective, randomised, double-blind, placebo-controlled, multicentre trial of collagenase from Clostridium histolyticum injection in 308 patients with Dupuytren’s disease, particularly with contractures of 20º or more. Collagenase injections were found to significantly reduce contractures and improve the range of movement in affected joints.26 An eight-year follow-up of a small subgroup of these patients showed recurrence of the disease in four of the six metacarpophalangeal joint (MCPJ) contractures treated and in both of the two PIPJ contractures, although the severity of recurrence in the MCPJ was less when compared with the initial disease.27

http://www.boneandjoint.org.uk/content/focus/current-treatment-dupuytren%E2%80%99s-disease-and-newer-advances

Posted Sep 10, 2017 by Jim 4055

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Dupuytrens Contracture stories
Four years ago at age 58, I noticed slight dimpling in the palm of my left, non dominant hand, below the ring finger. Research lead me to think I had Dupuytrens given that I'm of Scottish decent. Early in 2012 I noticed a lump on the arch of my left ...
Dupuytrens Contracture stories
  1965: Tonsillectomy 1968: Odd skin 2 inch rash/wheal on inside of left lower leg. undiagnosed 1978: Zadek operation, botched removal of big toenail rootbed 1980: Contracted Glandular Fever - lasted 12 months of debilitation - never felt 100% sinc...
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finger swelled for months after a thorn injury - repeated antibiotics made no difference. Lump appeared in Palm , followed by lump in foot. I worked out I have Dupuytrens and lederhose disease. However I have to see multiple different consultants and...
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The first 2 years of lumps growing on both feet were not painful. I had an MRI to rule out cancer. The following two years were very painful. I had physical therapy with some electrodes hooked up and a pulsating anti inflamitory hooked to my feet. I'...
Dupuytrens Contracture stories
Diagnosed at age 50, but had the condition for at least a year or more before diagnosis.  After researching and finding on Facebook, I engaged with other people that had Dupuytren's and Ledderhose Disease. I found out about using Radiation Therapy a...

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