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Human Dupuytren's Ex Vivo Culture for the Study of Myofibroblasts and Extracellular Matrix Interactions

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Surgical and Injection Interventions for Dupuytren's Disease: A Systematic Review Protocol.

Rodrigo Guerra Sabongi¹, Vinicius Ynoe de Moraes¹, João Baptista Gomes Dos Santos¹

¹Disciplina de Cirurgia da Mão e Membro Superior, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Revista Brasileira De Ortopedia

|September 10, 2025

Summary

This systematic review compares surgical and injection treatments for Dupuytren's disease (DD). It aims to rank interventions by effectiveness and safety using network meta-analysis to guide clinical decisions.

Keywords:

Dupuytren contracture collagenases fasciotomy systematic review'

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Area of Science:

Orthopedics and Hand Surgery
Evidence-Based Medicine
Pharmacology

Background:

Dupuytren's disease (DD) is a progressive fibrotic condition affecting the hand.
Current treatment options for DD include surgical and injection-based interventions.
A comprehensive comparison of these interventions is lacking.

Purpose of the Study:

To systematically review and network meta-analyze the effectiveness and safety of surgical and injection-based interventions for Dupuytren's disease.
To generate comparative estimates for all eligible interventions, incorporating direct and indirect evidence.
To rank treatments based on efficacy and safety profiles.

Main Methods:

Protocol adherence to PRISMA-P guidelines and PROSPERO registration.
Inclusion of randomized controlled trials (RCTs) for adult DD patients.
Comprehensive literature search across multiple databases and trial registries without restrictions.
Independent data extraction and risk of bias assessment (RoB2) by two reviewers.
Synthesis via random-effects pairwise and network meta-analyses, with GRADE for evidence certainty.
Subgroup analyses to explore heterogeneity.

Main Results:

Functional outcomes synthesized using patient-reported outcome measures (PROMs).
Comparative estimates of effectiveness and safety generated across all interventions.
Ranking of treatments based on synthesized efficacy and safety data.

Conclusions:

This systematic review addresses evidence gaps in Dupuytren's disease treatment.
Provides a robust synthesis of functional and safety outcomes for informed clinical decision-making.
Aims to guide clinicians in selecting the most effective and safe interventions for DD.