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RANDOMIZED CONTROLLED TRIAL OF LIMITED FASCIOTOMY WITH INJECTION OF ADIPOSE GRAFT FOR DUPUYTREN'S DISEASE
Marina Tommasini C Sambuy1, Hugo A Nakamoto1, Raul Bolliger1
1Universidade de São Paulo, Medical School, Hospital das Clínicas, Institute of Orthopedics and Traumatology, São Paulo, SP, Brazil.
Objective:
Dupuytren's disease is a genetic disorder related to the proliferation of myofibroblasts. The pluripotent property of stem cells present in adipose tissue inhibits myofibroblast proliferation. Our study sought to evaluate the effect of stem cell-rich fat grafts in patients that underwent limited fasciotomy.
Methods:
We studied 45 patients, in a single-blind, prospective, randomized clinical trial. All patients underwent limited fasciotomy. In one group, fat graft was injected.
Results:
The total passive extension deficit results did not exhibit a significant difference. Fat group exhibited worse functional score at 6 months and 1 year postoperatively, such as higher complication rates (43%), when compared with control group (8%), and more pain at 6 weeks follow-up.
Conclusion:
Fat grafting associated with limited fasciotomy promotes worse functional results compared to conventional limited fasciotomy in the short term. However, long-term results and recurrence rates should be further assessed. Level of Evidence II, Prospective comparative study.
