I haven't read anything about this on this forum. Has anyone had this procedure?

"Extensive Percutaneous Aponeurotomy and Lipografting
A recently introduced technique to treat Dupuytren disease is extensive percutaneous aponeurotomy with lipografting. [9] This procedure also uses a needle to cut the cords. The difference with the percutaneous needle fasciotomy is, that with this procedure the cord is cut at many places. The cord is also being separated from the skin to make place for the lipograft that is taken from the abdomen or ipsilateral flank. [9] This technique is very promising, because it shortens the recovery time, also the fatgraft results in supple skin. [9]
Before the hand is operated, a liposuction is done to the abdomen and ipsilateral flank to collect the lipograft. [9] The treatment can be performed under regional or general anesthesia. The digits are placed under maximal extension tension using a firm lead hand retractor. Then the surgeon makes multiple palmar puncture wounds with small nicks. The tension on the cords is crucial, because tight constricting bands are most susceptible to be cut and torn by the small nicks, whereas the relatively looser neurovascular structures are spared. After the cord is completely cut and separated from the skin the lipograft is injected under the skin. A total of about 5 to 10 ml is injected per ray. [9]
After the treatment the patient has to wear an extension splint for 5 tot 7 days. After this 1 week of postoperative splinting the patient is allowed to return to his normal activities and he is advised to use a night splint for up to 20 weeks. [9]
At this moment this treatment is only performed in Miami or in Rotterdam. Prospective randomized studies with other techniques are in process to fully determine its role in the treatment of Dupuytren’s disease. [9]"


[9] Hovius SE, Kan HJ, Extensive percutaneous aponeurotomy and lipografting: a new treatment for dupuytren disease. Extensive percutaneous aponeurotomy and lipografting: a new treatment for Dupuytren disease. Plast Reconstr Surg. 2011 Jul;128(1):221-8.

You can watch the presentation of Roger Khouri on PNF and lipografting at the Miami 2010 conference on YouTube http://www.youtube.com/watch?v=fmWiC5V76YI&lr=1 . Last weekened Hovius presented this technique also at the Dupuytren's symposium in Leuven, Belgium. It was video taped and - provided the quality of the videos is good - we will publish his talk also on the internet.

This method is elaborate, takes hours, and requires a surgical environment. I would expect that it costs about as much as surgery. Compared to surgery it offers much faster recovery and no scarring. Yet so far it remains unclear whether it produces better results than NA or whether it has better recurrence. Studies are obviously in progress.

Wolfgang