I am a 62 year old female in California. I have had two surgeries, one with graft,. I have also had xiaflex in finger and thumb. The finger has lasted two years, the thumb was just done. I now need another finger and thinking to do xiaflex again. Two doctors have not been too keen on radiation therapy (one is very renown at UCLA). But I'm curious if anyone RECENTLY has had success (or non success) with Needle aponeurotomy. I don't want to go to Idaho or L.A. again if I can help it, curious what anyone would recommend...

Thank you! Good info! I will try. Has someone been lately to dr denkler for NA?

Hi everyone ....
I'm a new member, and am glad to have discovered this site.
I'm a 69 y/o female, and had a NA done by Dr. Denkler in 2000 on my right ring finger. It was followed by PT, although he did not recommend it. I wore a splint at night, and after about 3 months the finger straightened out.

Maybe I'm an exception, but within 18 months my finger started contracting, and is now at stage 4.
I recently saw Dr. Kyle Bickel here in San Francisco, who claimed that NA is not effective in the long-term, and that in 90% of cases the condition returns. Perhaps that is professional bias on his part, since he only performs surgery. I found him to be quite arrogant, and a bit condescending, but he has the reputation of being one of the best, and was recommended by my Internist and Rheumatologist. He chastised me for waiting too long in consulting him, as a fasciectomy is now the only option.

None of the available treatments for Dupuytren's is a cure. The disease will come back, also after surgery. The recurrence period after surgery is longer than after NA but NA can often be repeated while surgery, depending on finger and joint, typically can only once or twice be repeated.

A clinical trial comparing NA and surgery by Annet van Rijssen et al. http://journals.lww.com/plasreconsurg/Ab...l_Trial.30.aspx won the Dupuytren Award in 2013 http://www.dupuytren-online.info/dupuytren_award.html. 5 years after the treatment 85% of the NA patients had recurrence and 21% of the surgical patients. From this one might conclude that surgery is the better treatment but of those patients who required a second treatment none who had had surgery opted for another surgery but 60% of those who had had NA decided for another NA.

BTW, Keith Denkler is also treating progressed stages of Dupuytren's, occasionally also with NA. The pictures in the section "Application of needle aponeurotomy (NA) to advanced stages of Dupuytren's contracture" on http://www.dupuytren-online.info/needle_aponeurotomy.html were provided by Dr. Denkler.

Wolfgang

pegsf:

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Hi everyone ....
I'm a new member, and am glad to have discovered this site.
I'm a 69 y/o female, and had a NA done by Dr. Denkler in 2000 on my right ring finger. It was followed by PT, although he did not recommend it. I wore a splint at night, and after about 3 months the finger straightened out.

Maybe I'm an exception, but within 18 months my finger started contracting, and is now at stage 4.
I recently saw Dr. Kyle Bickel here in San Francisco, who claimed that NA is not effective in the long-term, and that in 90% of cases the condition returns. Perhaps that is professional bias on his part, since he only performs surgery. I found him to be quite arrogant, and a bit condescending, but he has the reputation of being one of the best, and was recommended by my Internist and Rheumatologist. He chastised me for waiting too long in consulting him, as a fasciectomy is now the only option.

klm2050:

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No need for you to go to LA or Idaho. I had NA with Dr. Denkler in early 2014. I've had NA from 6 doctors - Dr. Denkler is HIGHLY skilled and VERY personable. I flew from Florida to see Dr. Denkler which gives you some idea of how good I think he is. Did the NA results last very long ? NO, but that's not his fault. I have had very aggressive Dupuytren's in both hands for 15 years - have had surgery, xiaflex and more Needle treatments than I can count. NONE of the treatments get lasting results for me.