{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:28Z","timestamp":1784557048886,"version":"3.55.0"},"reference-count":24,"publisher":"Bioscientifica","issue":"7","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["eor.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"\n Purpose<\/jats:title>\n \n \n Controversy exists regarding the comparative efficacy of collagenase injection and percutaneous needle fasciotomy in the treatment of Dupuytren contracture. The randomized controlled trials (RCTs) that have compared the two treatment methods have reported results mostly implying similar treatment efficacy, durability, and complications. We aimed to review these RCTs regarding methodical quality and risk of bias.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n \n We searched PubMed and Cochrane Library databases up to May 2023. All RCTs comparing collagenase injection with needle fasciotomy were included. Eligible articles were reviewed by two researchers, of whom one was blinded to each article\u2019s title, authors, year of publication, journal, and source of the studies. To assess methodical quality, we used the modified Jadad scale yielding a score of 0 (lowest quality) to 5 (highest quality). We assessed risk of bias with the Cochrane risk-of-bias tool (RoB 2).<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n \n Five studies were eligible, comprising 204 patients treated with collagenase injection and 209 patients treated with needle fasciotomy. The modified Jadad score ranged from 1 to 2 points in the five studies, and the overall risk of bias was high in all studies. Pretrial protocols could be retrieved for only two studies, revealing important discrepancies with the published articles.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n \n The published RCTs that have compared collagenase injection with needle fasciotomy in the treatment of Dupuytren contracture demonstrate a high risk of bias.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/eor-23-0211","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T07:14:29Z","timestamp":1719818069000},"page":"625-631","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":2,"title":["Bias in published randomized trials that compare collagenase injection with percutaneous needle fasciotomy in the treatment of Dupuytren disease: a systematic review"],"prefix":"10.1530","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1564-6974","authenticated-orcid":true,"given":"David","family":"Eckerdal","sequence":"first","affiliation":[{"name":"Department of Orthopedics, H\u00e4ssleholm-Kristianstad Hospitals, H\u00e4ssleholm, Sweden"},{"name":"Department of Clinical Sciences - Orthopedics, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Pakosta","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, H\u00e4ssleholm-Kristianstad Hospitals, H\u00e4ssleholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1023-712X","authenticated-orcid":true,"given":"Muhanned","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, H\u00e4ssleholm-Kristianstad Hospitals, H\u00e4ssleholm, Sweden"},{"name":"Department of Clinical Sciences - Orthopedics, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isam","family":"Atroshi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, H\u00e4ssleholm-Kristianstad Hospitals, H\u00e4ssleholm, Sweden"},{"name":"Department of Clinical Sciences - Orthopedics, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Bone and Joint Journal","first-page":"1138","article-title":"Treatment of Dupuytren\u2019s contracture: a systematic review","volume":"100\u2013B","author":"Soreide","year":"2018","unstructured":"Soreide EMurad MHDenbeigh JMLewallen EADudakovic ANordsletten Lvan Wijnen AJ & Kakar S. Treatment of Dupuytren\u2019s contracture: a systematic review. Bone and Joint Journal2018100\u2013B1138\u20131145. (https:\/\/doi.org\/10.1302\/0301-620X.100B9.BJJ-2017-1194.R2)"},{"key":"bib2","series-title":"Journal of Hand Surgery","first-page":"577","article-title":"One-year results of needle fasciotomy and collagenase injection in treatment of Dupuytren\u2019s contracture: a two-centre prospective randomized clinical trial","volume":"41","author":"Scherman","year":"2016","unstructured":"Scherman PJenmalm P & Dahlin LB. One-year results of needle fasciotomy and collagenase injection in treatment of Dupuytren\u2019s contracture: a two-centre prospective randomized clinical trial. Journal of Hand Surgery201641577\u2013582. (https:\/\/doi.org\/10.1177\/1753193415617385)"},{"key":"bib3","series-title":"New England Journal of Medicine","first-page":"968","article-title":"Injectable collagenase Clostridium histolyticum for Dupuytren\u2019s contracture","volume":"361","author":"Hurst","year":"2009","unstructured":"Hurst LCBadalamente MAHentz VRHotchkiss RNKaplan FTDMeals RASmith TMRodzvilla J & CORD I Study Group. Injectable collagenase Clostridium histolyticum for Dupuytren\u2019s contracture. New England Journal of Medicine2009361968\u2013979. (https:\/\/doi.org\/10.1056\/NEJMoa0810866)"},{"key":"bib4","series-title":"Hand Surgery and Rehabilitation","first-page":"322","article-title":"Complications after treating Dupuytren\u2019s disease. A systematic literature review","volume":"36","author":"Krefter","year":"2017","unstructured":"Krefter CMarks MHensler SHerren DB & Calcagni M. Complications after treating Dupuytren\u2019s disease. A systematic literature review. Hand Surgery and Rehabilitation201736322\u2013329. (https:\/\/doi.org\/10.1016\/j.hansur.2017.07.002)"},{"key":"bib5","series-title":"Plastic and Reconstructive Surgery","first-page":"469","article-title":"Five-year results of a randomized clinical trial on treatment in Dupuytren\u2019s disease: percutaneous needle fasciotomy versus limited fasciectomy","volume":"129","author":"van Rijssen","year":"2012","unstructured":"van Rijssen ALTer Linden H & Werker PMN. Five-year results of a randomized clinical trial on treatment in Dupuytren\u2019s disease: percutaneous needle fasciotomy versus limited fasciectomy. Plastic and Reconstructive Surgery2012129469\u2013477. (https:\/\/doi.org\/10.1097\/PRS.0b013e31823aea95)"},{"key":"bib6","series-title":"Journal of Hand Surgery","first-page":"498","article-title":"Percutaneous needle fasciotomy in Dupuytren\u2019s disease","volume":"31","author":"van Rijssen","year":"2006","unstructured":"van Rijssen AL & Werker PM. Percutaneous needle fasciotomy in Dupuytren\u2019s disease. Journal of Hand Surgery200631498\u2013501. (https:\/\/doi.org\/10.1016\/j.jhsb.2006.03.174)"},{"key":"bib7","series-title":"Plastic and Reconstructive Surgery","first-page":"e4046","article-title":"Treatment options for Dupuytren\u2019s disease: tips and tricks","volume":"10","author":"Denkler","year":"2022","unstructured":"Denkler KAPark KM & Alser O. Treatment options for Dupuytren\u2019s disease: tips and tricks. Plastic and Reconstructive Surgery202210e4046. (https:\/\/doi.org\/10.1097\/GOX.0000000000004046)"},{"key":"bib8","series-title":"Journal of Pharmacology and Pharmacotherapeutics","first-page":"100","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"1","author":"Schulz","year":"2010","unstructured":"Schulz KFAltman DG & Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Journal of Pharmacology and Pharmacotherapeutics20101100\u2013107. (https:\/\/doi.org\/10.4103\/0976-500X.72352)"},{"key":"bib9","series-title":"Journal of Hand Surgery","first-page":"873","article-title":"Comparison of treatment outcome after collagenase and needle fasciotomy for Dupuytren contracture: a randomized, single-blinded, clinical trial with a 1-year follow-up","volume":"41","author":"Str\u00f6mberg","year":"2016","unstructured":"Str\u00f6mberg JIbsen-S\u00f6rensen A & Frid\u00e9n J. Comparison of treatment outcome after collagenase and needle fasciotomy for Dupuytren contracture: a randomized, single-blinded, clinical trial with a 1-year follow-up. Journal of Hand Surgery201641873\u2013880. (https:\/\/doi.org\/10.1016\/j.jhsa.2016.06.014)"},{"key":"bib10","series-title":"Plastic and Reconstructive Surgery","first-page":"1464","article-title":"Comparison of treatment outcomes after collagenase injection and percutaneous needle fasciotomy for Dupuytren\u2019s contracture: objective and subjective comparisons with a 3-year follow-up","volume":"145","author":"Abe","year":"2020","unstructured":"Abe Y. Comparison of treatment outcomes after collagenase injection and percutaneous needle fasciotomy for Dupuytren\u2019s contracture: objective and subjective comparisons with a 3-year follow-up. Plastic and Reconstructive Surgery20201451464\u20131474. (https:\/\/doi.org\/10.1097\/PRS.0000000000006828)"},{"key":"bib11","series-title":"Journal of Hand Surgery","first-page":"321","article-title":"Injectable collagenase versus percutaneous needle fasciotomy for Dupuytren contracture in proximal interphalangeal joints: a randomized controlled trial","volume":"42","author":"Skov","year":"2017","unstructured":"Skov STBisgaard TS\u00f8ndergaard P & Lange J. Injectable collagenase versus percutaneous needle fasciotomy for Dupuytren contracture in proximal interphalangeal joints: a randomized controlled trial. Journal of Hand Surgery201742321\u2013328.e3. (https:\/\/doi.org\/10.1016\/j.jhsa.2017.03.003)"},{"key":"bib12","series-title":"Plastic and Reconstructive Surgery","first-page":"365","article-title":"Three-year recurrence of Dupuytren contracture after needle fasciotomy or collagenase injection: a randomized controlled trial","volume":"151","author":"J\u00f8rgensen","year":"2023","unstructured":"J\u00f8rgensen RWJensen CH & J\u00f8rring S. Three-year recurrence of Dupuytren contracture after needle fasciotomy or collagenase injection: a randomized controlled trial. Plastic and Reconstructive Surgery2023151365\u2013371. (https:\/\/doi.org\/10.1097\/PRS.0000000000009847)"},{"key":"bib13","series-title":"PLoS Medicine","first-page":"e1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","unstructured":"Moher DLiberati ATetzlaff JAltman DG & PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine20096e1000097. (https:\/\/doi.org\/10.1371\/journal.pmed.1000097)"},{"key":"bib14","series-title":"Controlled Clinical Trials","first-page":"1","article-title":"Assessing the quality of reports of randomized clinical trials: is blinding necessary?","volume":"17","author":"Jadad","year":"1996","unstructured":"Jadad ARMoore RACarroll DJenkinson CReynolds DJGavaghan DJ & McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary?Controlled Clinical Trials1996171\u201312. (https:\/\/doi.org\/10.1016\/0197-2456(9500134-4)"},{"key":"bib15","series-title":"Journal of Hand Surgery","first-page":"727","article-title":"The quality of reporting and outcome measures in randomized clinical trials related to upper-extremity disorders","volume":"29","author":"Gummesson","year":"2004","unstructured":"Gummesson CAtroshi I & Ekdahl C. The quality of reporting and outcome measures in randomized clinical trials related to upper-extremity disorders. Journal of Hand Surgery200429727\u2013734. (https:\/\/doi.org\/10.1016\/j.jhsa.2004.04.003)"},{"key":"bib16","series-title":"BMJ","first-page":"l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","unstructured":"Sterne JACSavovi\u0107 JPage MJElbers RGBlencowe NSBoutron ICates CJCheng H-YCorbett MSElridge SM, et al.RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ2019366l4898. (https:\/\/doi.org\/10.1136\/bmj.l4898)"},{"key":"bib17","series-title":"Clinical Epidemiology","first-page":"531","article-title":"Imbalance p values for baseline covariates in randomized controlled trials: a last resort for the use of p values? A pro and contra debate","volume":"10","author":"Stang","year":"2018","unstructured":"Stang A & Baethge C. Imbalance p values for baseline covariates in randomized controlled trials: a last resort for the use of p values? A pro and contra debate. Clinical Epidemiology201810531\u2013535. (https:\/\/doi.org\/10.2147\/CLEP.S161508)"},{"key":"bib18","series-title":"Cochrane Database of Systematic Reviews","first-page":"CD010143","article-title":"Surgery for Dupuytren\u2019s contracture of the fingers","volume":"2015","author":"Rodrigues","year":"2015","unstructured":"Rodrigues JNBecker GWBall CZhang WGiele HHobby JPratt AL & Davis T. Surgery for Dupuytren\u2019s contracture of the fingers. Cochrane Database of Systematic Reviews20152015CD010143. (https:\/\/doi.org\/10.1002\/14651858.CD010143.pub2)"},{"key":"bib19","series-title":"Acta Orthopaedica","first-page":"517","article-title":"Collagenase injections for Dupuytren disease: 3-year treatment outcomes and predictors of recurrence in 89 hands","volume":"90","author":"Nordenskjold","year":"2019","unstructured":"Nordenskjold JLauritzson AAkesson A & Atroshi I. Collagenase injections for Dupuytren disease: 3-year treatment outcomes and predictors of recurrence in 89 hands. Acta Orthopaedica201990517\u2013522. (https:\/\/doi.org\/10.1080\/17453674.2019.1663472)"},{"key":"bib20","series-title":"Journal of Hand Surgery","first-page":"1597","article-title":"Dupuytren contracture recurrence following treatment with collagenase Clostridium histolyticum (CORDLESS [Collagenase Option for Reduction of Dupuytren Long-Term Evaluation of Safety Study]): 5-year data","volume":"40","author":"Peimer","year":"2015","unstructured":"Peimer CABlazar PColeman SKaplan FTDSmith T & Lindau T. Dupuytren contracture recurrence following treatment with collagenase Clostridium histolyticum (CORDLESS [Collagenase Option for Reduction of Dupuytren Long-Term Evaluation of Safety Study]): 5-year data. Journal of Hand Surgery2015401597\u20131605. (https:\/\/doi.org\/10.1016\/j.jhsa.2015.04.036)"},{"key":"bib21","series-title":"Journal of Hand and Microsurgery","first-page":"150","article-title":"Percutaneous needle fasciotomy versus collagenase injection for Dupuytren\u2019s contracture: a systematic review of comparative studies","volume":"13","author":"Hirase","year":"2021","unstructured":"Hirase TSuresh RCotton MOHan ABurn MBHarris JD & Liberman SR. Percutaneous needle fasciotomy versus collagenase injection for Dupuytren\u2019s contracture: a systematic review of comparative studies. Journal of Hand and Microsurgery202113150\u2013156. (https:\/\/doi.org\/10.1055\/s-0040-1721876)"},{"key":"bib22","series-title":"BMC Musculoskeletal Disorders","first-page":"252","article-title":"Intervention randomized controlled trials involving wrist and shoulder arthroscopy: a systematic review","volume":"15","author":"Tadjerbashi","year":"2014","unstructured":"Tadjerbashi KRosales RS & Atroshi I. Intervention randomized controlled trials involving wrist and shoulder arthroscopy: a systematic review. BMC Musculoskeletal Disorders201415252. (https:\/\/doi.org\/10.1186\/1471-2474-15-252)"},{"key":"bib23","series-title":"Annals of General Psychiatry","first-page":"25","article-title":"A systematic appraisal of allegiance effect in randomized controlled trials of psychotherapy","volume":"14","author":"Dragioti","year":"2015","unstructured":"Dragioti EDimoliatis IFountoulakis KN & Evangelou E. A systematic appraisal of allegiance effect in randomized controlled trials of psychotherapy. Annals of General Psychiatry20151425. (https:\/\/doi.org\/10.1186\/s12991-015-0063-1)"},{"key":"bib24","series-title":"BMC Musculoskeletal Disorders","first-page":"939","article-title":"Short-term efficacy and adverse effects of collagenase Clostridium histolyticum injections, percutaneous needle fasciotomy and limited fasciectomy in the treatment of Dupuytren\u2019s contracture: a network meta-analysis of randomized controlled trials","volume":"23","author":"Obed","year":"2022","unstructured":"Obed DSalim MSchlottmann FBingoel ASPanayi ACDastagir KVogt PM & Koenneker S. Short-term efficacy and adverse effects of collagenase Clostridium histolyticum injections, percutaneous needle fasciotomy and limited fasciectomy in the treatment of Dupuytren\u2019s contracture: a network meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders202223939. (https:\/\/doi.org\/10.1186\/s12891-022-05894-6)"}],"container-title":["EFORT Open Reviews"],"original-title":[],"link":[{"URL":"https:\/\/eor.bioscientifica.com\/view\/journals\/eor\/9\/7\/EOR-23-0211.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eor.bioscientifica.com\/downloadpdf\/journals\/eor\/9\/7\/EOR-23-0211.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/eor.bioscientifica.com\/downloadpdf\/journals\/eor\/9\/7\/EOR-23-0211.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:51:20Z","timestamp":1784555480000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/eor\/article\/9\/7\/625-631\/2648"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,1]]},"references-count":24,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.1530\/eor-23-0211","relation":{},"ISSN":["2058-5241"],"issn-type":[{"value":"2058-5241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,1]]}}}