| Abstract [eng] |
Introduction First carpometacarpal joint arthritis, also known as basal thumb arthritis, is a common condition affecting the aging population, leading to pain and decreased function of the hand. Treatment varies and focuses on symptoms alleviation and improvement of function. Currently there is no consensus on gold standard treatment of first carpometacarpal joint arthritis, therefore further studies are in need. This review aims to summarize the current available treatment options and potentially effective measures for first carpometacarpal joint arthritis, including conservative and surgical interventions. Highlights the effectiveness of interventions and the potential risks of complications. Methods Literature search through the PubMed database, apply filters with “meta-analysis” and “full-text articles available”, and source literature with keywords. Establish a systematic literature review via the Preferred Reporting Items for Systematic reviews and Meta-Analyses flow chart, selection through the PubMed platform. Results and discussion 38 studies are identified and included in this review, including 30 conservative treatment studies and 8 surgical treatment studies. 1 dietary study was found, and it shows no effectiveness in osteoarthritis. 14 pharmacological treatment studies, only a few substances show effectiveness, oral non-steroidal anti-inflammatory drugs and oral corticosteroids have a consistent effectiveness among all studies. Novel synergistic drugs GCSB-5 and CRx-102 have effectiveness on hand osteoarthritis but are not used on a regular basis. Injection therapies are ineffective in these studies. 14 physical therapy-related studies, with another study including both pharmacological and physical therapy. Most physical therapies in these studies show effectiveness on hand osteoarthritis and first carpometacarpal joint arthritis, including orthoses or splints, exercise-based therapy, heat therapy, and pulse electromagnetic field therapy. Acupuncture has a doubtful outcome, and further research is recommended. 8 surgical studies are included in this review, including autologous fat and platelet-rich plasma injections, arthroscopic-assisted techniques, first metacarpal extension osteotomy, arthrodesis, simple trapeziectomy, trapeziectomy with ligament and tendon interposition, and joint replacement surgeries. All these surgical techniques show effectiveness in pain and function improvement, apart from the first metacarpal extension osteotomy, which does not improve the function of the hand. Conclusion First carpometacarpal arthritis has various treatment options, this review has its limitations due to the inability to find other known interventions studies with meta-analysis. Initial treatment is recommended to treat oral non-steroidal anti-inflammatory drugs, corticosteroids, splints, exercise, heat, and pulse electromagnetic field. Surgical treatment options recommended for early-stage disease are treated with autologous fat and platelet-rich plasma injections; Later stages are treated with simple trapeziectomy, trapeziectomy with ligament and tendon interposition, and joint replacement. |
