Randy, I really would presume a higher reccurence rate when using NA. A statement from the probably well-known site www.dupuytren.org that promotes NA:

"Five years results (of NA) show that recurrence rate is quite comparable with surgical one, although they seem slightly earlier.
Nevertheless, it is easier to repeat fasciotomy than accept the prospect of a more complicated operation."

The reason why I would expect hight recurrence rates for NA is because Dupuytren nodules grow by collagen lumping onto initial little pieces of collagen. Surgery attempts to remove the collagen completely and thus (theoretically) minmizes the chance of recurrence. In real life it very much depends on the quality of the surgeon and on chance whether this works out.

NA on the other hand does not remove the collagen nodule/cord but damages it to an extent that the finger can overcome the tension and can stretch again. It's basically a mechanical thing and that's why it works more or less immediately. But the Dupuytren cord is still there and can resume its growth. Actually I would expect it to grow. But because it has been stretched, it will probably take longer to build a strong enough tension to bend the finger again.

Collagenase is an enzyme that dissolves collagen. Thus, a collagnase injection is considered to remove the collagen lump and (theoretically) rhe Dupuytren nodule should not come back again. As far as I know the recurrance rate actually is quite low so far. The current concern with collagenase is probably that it for sure won't stay just within the nodule where it has been injected. The question is whether it does damage elsewhere. Maybe it does good, e.g. eliminating neigbouring, so far undetected Dupuytren mini-nodules. Who knows.

The subject of Collagenase for Dupuytren's is moot, as I believe BioSpecifics' plans for completing its FDA approval are essentially dead.

Someone will now jump in here and say no, they just spoke with a doctor and the trials 'will begin soon'. That's been the case for at least the last 7 years, and BioSpecifics financial picture seems to be bleaker than ever.

I see little advantage to collagenase over NA anyway, and it's likely to be much more expensive. This may account for the apparent lack of interest in marketing the product.

Wolfgang,

We all learn from each other as our Surgeons seem to be mute.

Jim h,

My bother in NA.........

Excuse my wide Eyed Optimism and I'll excuse your Informed Pessimism.