Percutaneous Aponeurotomy Combined with Autologous Fat Grafting for Early Dupuytren's Disease.

BACKGROUND

Percutaneous needle aponeurotomy (PNA) is a well-established minimally invasive technique for treating early-stage Dupuytren's disease; however, recurrence remains a concern. Recent studies have suggested that autologous fat grafting may have regenerative and antifibrotic effects, potentially improving clinical outcomes when combined with minimally invasive techniques.

METHODS

In this current study, 57 patients with Tubiana stage 1-3 Dupuytren's disease were treated with PNA combined with autologous fat grafting between 2022 and 2024. Fat was harvested from the abdomen and processed via the cotton gauze rolling technique. Joint contractures were evaluated preoperatively and at 1 and 12 months postoperatively. Postoperative recovery time, complication rates, and recurrence were also analyzed.

RESULTS

Significant improvements were observed in both MCP and PIP joint contractures at 1 and 12 months (p < 0.001). The mean follow-up was 17.4 ± 3.4 months. No clinical recurrences were noted. Only 7% of patients experienced minor, self-limiting complications. Most patients resumed daily activities within one week postoperatively.

CONCLUSIONS

PNA combined with autologous fat grafting offers a safe, effective, and biologically favorable approach for managing early-stage Dupuytren's disease. The technique promotes rapid recovery, minimizes complications, and may reduce recurrence through adipose tissue's regenerative and antifibrotic effects. This combined strategy represents a promising minimally invasive alternative to traditional open surgery. The addition of fat grafting provided improved tissue pliability, reduced postoperative pain, and enhanced healing.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266 .