4.6 Article

Factors Associated with the Development, Progression, and Outcome of Dupuytren Disease Treatment: A Systematic Review

Journal

PLASTIC AND RECONSTRUCTIVE SURGERY
Volume 148, Issue 5, Pages 753E-763E

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PRS.0000000000008420

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Funding

  1. Intercalated Bachelor of Science Degree in Surgery Award
  2. National Institute for Health Research Postdoctoral Fellowship [PDF-2017-10-075]
  3. National Institute for Health Research
  4. National Institutes of Health Research (NIHR) [PDF-2017-10-075] Funding Source: National Institutes of Health Research (NIHR)

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This systematic review examined the potential association of various factors with the development, progression, treatment outcome, and recurrence of Dupuytren disease, identifying 46 candidate factors associated with the development of the disease. It challenges conventional notions of diathesis factors and suggests that traditional diathesis factors may not significantly impact treatment outcomes based on current evidence.
Background: The factors typically considered to be associated with Dupuytren disease have been described, such as those in the Dupuytren diathesis. However, the quality of studies describing them has not been appraised. This systematic review aimed to analyze the evidence for all factors investigated for potential association with the development, progression, outcome of treatment, or recurrence of Dupuytren disease. Methods: A systematic review of the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature databases was conducted using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant methodology up to September of 2019. Articles were screened in duplicate. Prognostic studies were quality assessed using the Quality in Prognosis Study tool. Results: This study identified 2301 records; 51 met full inclusion criteria reporting data related to 54,491 patients with Dupuytren disease. In total, 46 candidate factors associated with the development of Dupuytren disease were identified. There was inconsistent evidence between the association of Dupuytren disease and the presence of classic diathesis factors. The quality of included studies varied, and the generalizability of studies was low. There was little evidence describing the factors associated with functional outcome. Conclusions: This systematic review challenges conventional notions of diathesis factors. Traditional diathesis factors are associated with disease development and recurrence, although they are not significantly associated with poor outcome following intervention based on the current evidence.

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