Multi-needle aponeurotomy for advanced Dupuytren's disease: preliminary results of safety and efficacy (MNA 1 study)

AIM

To assess the safety and efficacy of multi-needle aponeurotomy (MNA) for advanced Duputren's disease.

METHODS

This prospective study included patients with age more than 17 years, Dupuytren's contracture with palmo-digital or poly-digital involvement, presumed NA number needed to treat>4, and availability for at least 1-month follow-up after MNA. Outcome measures were Tubiana score and passive extension deficit, after MNA and at 1 and 6 months; self-assessed disability and satisfaction at 1 and 6 months; and adverse events (AEs).

RESULTS

Thirty patients were included. MNA was performed on 37 hands and 99 rays. Among 25 assessed MNA sessions for treatment-related discomfort, patients considered 22 (88%) not at all to moderately painful. Six minor AEs, representing 2 for every 100 NAs, were reported. Tubiana scores at baseline (5.3±2.3, n=35) were improved after treatment (1.7±1.8, n=32, P<0.0001), at 1 month (2.2±1.4, n=26, P<0.0001) and at 6 months (2.8±2.7, n=19, P<0.01). Passive extension deficit was greatly reduced after treatment and persisted at follow-up. Disability scores at baseline (27.6±26.9, n=37) were reduced at 1 month (13.2±19.5, n=26, P=0.02) and at 6 months (5.2±11.6, n=20, P<0.001). Patients were highly satisfied at 1 month (100%, n=25) and 6 months (95%, n=19).

CONCLUSION

MNA appears safe and effective for advanced Dupuytren's disease. It could become a treatment of reference and contribute to reducing the need for surgery in this indication.

A double-blind study of the analgesic action of benorylate suspension in osteoarthritis of the hip and knee

This study compared benorylate suspension and placebo in a double-blind randomised cross-over design to investigate their analgesic effect in osteoarthritis of the hip and the knee. Benorylate and placebo were each given for 7 days. Assessment of efficacy and tolerance was carried out on the 7th day of each period. The results were subjected to sequential analysis and the analgesic effect of benorylate suspension was significantly demonstrated after 8 case reports. Mild digestive side effects appeared in 30% of patients. In addition, benorylate suspension was well tolerated in an open trial carried on for 30 to 90 days in 7 patients.