The consequences of different definitions for recurrence of Dupuytren's disease

Background: Recurrence rates are important in the evaluation of the effectiveness of treatment for Dupuytren's disease (DD). In the literature, recurrence rates vary between 0% and 100%. The definition of recurrence of DD after treatment is inconsistently used. The aim of this study is to review all definitions of recurrence after treatment of DD and to evaluate the impact of using these definitions on a single cohort of patients treated for DD. Methods: A literature search was performed in PubMed and Embase to identify studies. Titles and abstracts were analysed to collect all articles that described recurrence rates or definitions of recurrence. Two independent reviewers selected relevant studies and extracted data. The different definitions of recurrence were applied on our data set of 66 patients. Results: Of the 113 articles reporting recurrent rates of DD, 56 (49%) presented a definition of recurrence. We could categorise the definitions into three groups. By applying the different definition on our data set of a randomised controlled trial, the recurrence rates ranged from 2% to 86%. Conclusions: In the literature, different definitions of recurrence of DD are used and many authors failed to define recurrence. This study shows that the wide range of reported recurrence rates may largely be contributed by inconsistency in recurrence definitions. As a result, it is difficult or even impossible to compare recurrence rates between different treatments reported in the literature. The study indicates that consensus on a recurrence definition is needed. (C) 2012 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.