Office-Based Percutaneous Fasciotomy for Dupuytren Contracture

Chambers, Jonathan; Pate, Taylor; Calandruccio, James H.

doi:10.1016/j.ocl.2020.02.008

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…Open With studies showing conflicting advantages and disadvantages for each procedure and our study finding significant cost differences between each procedure, it is important to discuss patient expectations, including pricing, outcomes, recurrence, duration of recovery, and need for formal occupational therapy, when selecting a treatment modality. 5,[9][10][11] There are several limitations to mention regarding our study. First, the study is a retrospective cohort study.…”

Section: Discussionmentioning

confidence: 99%

“…Our data found that NF had significantly lower cost (US $2239) compared with OF (US $3413) in 2018. With studies showing conflicting advantages and disadvantages for each procedure and our study finding significant cost differences between each procedure, it is important to discuss patient expectations, including pricing, outcomes, recurrence, duration of recovery, and need for formal occupational therapy, when selecting a treatment modality 5,9–11 …”

Section: Discussionmentioning

confidence: 99%

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Cost Analysis and National Trends in the Treatment of Dupuytren Contracture Comparing Collagenase Injection, Needle Fasciotomy, and Open Fasciectomy Procedures

Jain¹,

Tarabishy

Carter

et al. 2021

Ann Plast Surg

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Background Dupuytren contracture (DC) is a common disorder characterized by progressive fibrosis of palmar fascia. This study analyzed cost trends of 3 common treatments for DC: fasciotomy, fasciectomy, and collagenase injection (CI)/cord manipulation. Methods The Vizient Clinical Data/Resource Manager electronic database was reviewed for all procedures for the treatment of DC at participating hospitals in the United States (US) from October 1, 2015, to September 1, 2019. Cases were placed into 1 of 3 categories: (1) CI, (2) needle fasciotomy (NF), and (3) open fasciectomy (OF). Total and direct costs were averaged for each procedure and compared nationally and regionally. Temporal trends and specific market share were analyzed. One-tailed t test and Pearson correlation analysis was performed (P < 0.05 and r > 0.9 or r < −0.9 was considered significant). Results A total of 22,974 total cases were identified. A total of 16,966 OF, 3962 NF, and 2046 CI were performed. There was a nearly a 4-fold increase in number of procedures to treat DC from 2015 to 2018. Market share percentage of each procedure stayed relatively similar over time. However, market share percentage differed between procedures. Needle fasciotomy had the lowest market share percentage approximately 7%. Collagenase injection had the highest average cost at US $4453.66 and was significantly higher than OF at US $3394.90 and NF at US $2010.75. Cost and distribution of procedures were further analyzed by geographic regions. In 2018, 32% of procedures performed were in the Northeastern US, 29% in the Midwestern US, 23% in the Southern US, and 16% in the Western US. Total number of Dupuytren procedures increased more than 300% in all regions across the US from 2015 to 2018. In every region, NF was the lowest cost intervention. Cost of OF and CI varied between regions and was often the most expensive intervention. Conclusions Treatment of DCs with NF seems to be the least costly treatment option. Needle fasciotomy seems to be the least commonly performed procedure. Regional data show variations in the cost of OF and CI. However, OF has the majority market share nationally and regionally. Although the cost of these procedures seems to vary regionally, the type of procedures being performed seem to be similar across regions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cost Analysis and National Trends in the Treatment of Dupuytren Contracture Comparing Collagenase Injection, Needle Fasciotomy, and Open Fasciectomy Procedures

Jain¹,

Tarabishy

Carter

et al. 2021

Ann Plast Surg

View full text Add to dashboard Cite

show abstract

“…Though an established technique with documented safety in several large series studies including that by Therkelsen et al., 1 there is a relative paucity in the literature regarding the provision of ‘office-based’ PNF which has also shown to be effective without compromise to patient safety. 2 The increased uptake of such practices may be vital in conserving theatre space, a resource which is likely to remain limited for the foreseeable future, enabling greater capacity for more demanding procedures and cases with greater need and/or complexity. As the demand for elective hand surgery continues to rise 3 against the expected backdrop of economic recession and rationed healthcare, it may be essential to increase the provision of more sustainable and cost-effective approaches to treating surgical hand disease.…”

mentioning

confidence: 99%