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Department of Clinical Sciences - Orthopedics, Lund University, Lund, Sweden
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morbidity associated with fasciectomy, less invasive techniques such as collagenase injection and percutaneous needle fasciotomy (PNF) have been increasingly used for treating DD ( 1 , 2 ). Both these methods have been shown to be safe with good short
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discomfort when the flexion deformity is ≥ 15°. 36 Fig. 3. Metacarpophalangeal joint contracture > 30º, a surgical indication. Collagenase This treatment poses as an alternative to surgery which is still the standard of care for
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that this system is a quick and effective method for debridement. 39 Furthermore, Clostridial collagenase is a novel enzymatic debridement method and that is reported as tolerable and clinically efficacious in achieving a viable wound bed. However
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is a slow, continuous process consisting of degradation and deposition of ECM proteins. These primarily include proteoglycans and collagens. Various MMPs, ADAMs and ADAMTSs participate in the tendon repair process. For example, collagenases, such as
Low-dose dexamethasone during arthroplasty
What do we know about the risks?
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on the synthesis of collagen type I and III, collagenase, and tissue inhibitors of metalloproteinases . Br J Dermatol 2002 ; 147 : 859 - 68 . 35 Ehrlich HP , Tarver H , Hunt TK . Effects of vitamin A and
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needle fasciotomy and collagenase injections have a faster recovery, but incomplete correction and recurrence are markedly more frequent than open surgery ( 5 ). Fasciectomy can be augmented with skin grafting in cases of incomplete skin closure or to
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treatment . Disabil Rehabil 2008 ; 30 ; 22 : 1666 - 1676 . 83 Chen YJ , Wang CJ , Yang KD , et al. . Extracorporeal shock waves promote healing of collagenase-induced Achilles tendinitis and increase TGF-beta1 and IGF
IRCCS Humanitas Research Hospital, Milan, Italy
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IRCCS Humanitas Research Hospital, Milan, Italy
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digestion with collagenase and trypsin, but, following safety and regulatory concerns, minimally manipulative methods were developed, 45 exploiting mechanical forces such as centrifugation or microfragmentation in order to obtain a readily injectable
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Its drawbacks are time and financial cost. Enzymatic debridement involves debridement of necrotic tissue by topical enzymes such as streptokinases, trypsin, papain, fibrinolysin-DNase, collagenase, papainurea and streptodornase. These agents are
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; 278 : 45539 – 45545 . 51. Dejica VM Mort JS Laverty S et al. Increased type II collagen cleavage by cathepsin K and collagenase activities with aging and osteoarthritis in human articular cartilage . Arthritis
