International Patient Survey (Part 2: Ledderhose Disease)


Country

N

Country

N

USA

471

UK

163

Canada

46

Ireland

10

Australia

36

France

7

Germany

190

Other Europe

26

Holland

14

Africa

8

Austria

11

Rest of the world

18



Data correction was performed as described in part 1 (Wach and Manley 2016). Note that patients did not have to answer all questions; therefore, for any question the number of responses might be less than the total number of participants.



49.3.2 Age of Onset for Ledderhose Disease


The effect of gender, positive family history and having other (related) fibromatoses on the age of onset of Ledderhose Disease was evaluated. 888 patients specified their age of onset for LD, with an average age of onset of 44.6.


49.3.2.1 Influence of Gender


Figure 49.1 shows that men develop Ledderhose Disease earlier than women. The average age of onset found for men is 41.4 (median = 43) and for women 47.5 (median = 50).

A352582_1_En_49_Fig1_HTML.gif


Fig. 49.1
Influence of gender on the age of onset of Ledderhose Disease


49.3.2.2 Family History and Concurrent Dupuytren Disease


Having a family history means that close relatives have or had Dupuytren and/or Ledderhose Disease. 528 patients reported having family history, 214 stated that they don’t know (‘unknown’) and 251 had no family history or were not aware of any relatives with DD or LD. Below we are counting ‘unknown’ and ‘no’ as having no (known) family history. Patients with family history have an average age of onset of 43.3 and without family history an average age of onset of 46. Note that these are not prevalence data, i.e. having a family history might well mean that the chances to develop LD (or DD) are much higher, but the average age of onset is only a few years earlier.

78.2 % of the LD patients report suffering also from Dupuytren Disease. Overall, concurrent DD does not seem to have strong effect: the average age of onset for patients also suffering from DD is 45.4, even a little but not significantly later than the total average of 44.6. A strong difference appears when it is additionally taken into account which disease started first: patients with concurrent DD who had Ledderhose first report an onset of LD at 38, and if DD came first, the onset of LD was at 49.4. That difference is to some extent ‘natural’ because those with an early onset of Ledderhose Disease are all in the group ‘Ledderhose first’, thus lowering the average age of onset. If patients with an onset of LD <30 are excluded from the analysis, the average age of onset for the group with ‘Ledderhose first’ jumps to 46.8, while for ‘Dupuytren first’, the age of onset for LD increases only slightly to 51.


49.3.2.3 Lifestyle: Smoking and Drinking


Smoking is affecting the onset of Ledderhose Disease as shown in Fig. 49.2. For comparison also included in Fig. 49.2 are results for not smoking women without family history thus eliminating influences that might cause an earlier onset.

A352582_1_En_49_Fig2_HTML.gif


Fig. 49.2
Influence of smoking on the age of onset of Ledderhose Disease

We found an average age of onset of Ledderhose Disease for smokers 40.2 (median = 40), for nonsmokers 45.0 (median = 48) and for nonsmoking women without family history 49.6 (median = 52).

For alcohol consumption, we observed no significant effect on the age of onset of LD. The average was 44.7 if drinking more than 2 glasses of wine/pints of beer per day, 44.2 if drinking less than 2 glasses of wine/pints of beer per day and 45.2 if not drinking at all. Our survey did not inquire about specifically heavy alcohol consumption.


49.3.3 Related Diseases


Of the patients with Ledderhose Disease, 78 % also have Dupuytren Disease, 22 % have or had frozen shoulder (of the DD patients 18 % have or had frozen shoulder), 26 % had knuckle pads (DD patients: 15 %), 16 % had thyroid problems (DD patients: 12 %), 5 % had diabetes (same as for DD patients), 1.3 % had epilepsy and 1.4 % had liver problems. 7 % of the male respondents have or had Peyronie disease (DD patients: 9.5 %).

For diseases with more than 50 respondents affected, we tested whether this co-morbidity is affecting the age of onset of Ledderhose Disease (average age of onset for all patients = 44.6, median = 47). We did not find a significant effect, except maybe for knuckle pads (Table 49.2).


Table 49.2
Age of onset of LD for various co-morbidities

















































Co-morbidity

Frozen shoulder

Knuckle pads

Thyroid

Diabetes

DD = yes

DD = No

Peyronie

Ave. onset

45.7

39.4

48.4

44.3

45.4

41.7

44.8

Median

49

41.5

50

45

48

44

47

N

220

256

158

53

782

218

71


49.3.4 Patients’ Rating of Medical Counselling


Patients were asked ‘Given your experience to date, how would you rank the medical community’s knowledge and experience with Ledderhose Disease?’ on a range of 1–10 with 1 = no knowledge and 10 = knew everything. Figure 49.3 shows results by country, whereby countries with less than 100 respondents are omitted. For better overview, the ratings 1–3 (= bad; red), 4–7 (= medium; yellow) and 8–10 (= good; green) are combined.
Oct 4, 2017 | Posted by in ORTHOPEDIC | Comments Off on International Patient Survey (Part 2: Ledderhose Disease)

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