Name of the Procedure:

Injection of Collagenase, Clostridium Histolyticum (HCPCS Code J0775) Common Names: Collagenase Injection, Xiaflex Injection

Summary

This procedure involves injecting a small amount (0.01 mg) of Clostridium histolyticum collagenase into the affected area. The enzyme collagenase works by breaking down the collagen that causes certain medical conditions.

Purpose

This procedure is primarily used to treat conditions such as Dupuytren's contracture and Peyronie's disease. The goal is to break down the excess collagen that is causing thickened scar tissue and, consequently, deformities or limited range of motion.

Indications

• Dupuytren's contracture (a condition that affects the hands and fingers)
• Peyronie's disease (a condition that affects the penis)
• Other conditions involving excessive collagen deposits Patients should be diagnosed with confirmed collagen-related deformities.

Preparation

• The patient may need to undergo imaging tests to confirm the location and extent of collagen buildup.
• Patients should inform the healthcare provider of all medications and supplements they are taking.
• No specific preparation like fasting is typically required.

Procedure Description

1. The procedure typically starts with an examination and marking of the injection site.
2. Local anesthesia may be administered to numb the area.
3. The healthcare provider injects the collagenase enzyme directly into the affected tissue.
4. The enzyme works to break down the collagen, which can then be gently manipulated by the provider to improve the condition.

Duration

The procedure usually takes about 30 minutes, although this can vary.

Setting

The procedure is generally performed in an outpatient clinic or a specialized medical office.

Personnel

• Performing Physician (often a specialist in orthopedics or urology)
• Supporting Nurses
• Possible involvement of an anesthesiologist if more complex sedation is required

Risks and Complications

• Common: Local swelling, bruising, pain at the injection site
• Rare: Infection, allergic reactions, tendon injury
• Complications are generally manageable with follow-up care and medications.

Benefits

Patients can expect improved mobility and reduced deformity. Symptom relief often becomes noticeable within a few days to a few weeks, depending on the condition treated.

Recovery

• Most patients can resume normal activities within a couple of days.
• Follow-up appointments are recommended to monitor progress and ensure the treatment's efficacy.
• Patients may be given exercises to perform at home to enhance recovery.

Alternatives

• Surgical options such as fasciectomy (removal of contracted fascia)
• Non-invasive treatments like physical therapy or radiotherapy
• Pros and cons should be discussed with the healthcare provider to determine the best course of action.

Patient Experience

During the procedure, patients typically experience minimal discomfort due to local anesthesia. Post-procedure, some pain and soreness are common but manageable with over-the-counter pain medication. Most patients report significant improvement in symptoms and function after the injection series.