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Total joint arthroplasty for thumb carpometacarpal joint osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.

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اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: Medical Journals Sweden AB Country of Publication: Sweden NLM ID: 101231512 Publication Model: Electronic Cited Medium: Internet ISSN: 1745-3682 (Electronic) Linking ISSN: 17453674 NLM ISO Abbreviation: Acta Orthop Subsets: MEDLINE
    • بيانات النشر:
      Publication: 2022- : Uppsala, Sweden : Medical Journals Sweden AB
      Original Publication: Basingstoke, Hampshire, UK : Taylor & Francis, c2005-
    • الموضوع:
      Carpometacarpal Joints*/surgery ; Carpometacarpal Joints*/physiopathology ; Osteoarthritis*/surgery ; Thumb*/surgery ; Thumb*/physiopathology ; Randomized Controlled Trials as Topic*; Humans ; Arthroplasty, Replacement/methods ; Arthroplasty, Replacement/adverse effects ; Trapezium Bone/surgery
    • نبذة مختصرة :
      Background and Purpose: Thumb carpometacarpal (CMC) joint osteoarthritis (OA) is increasingly treated with total joint arthroplasty (TJA). We aimed to perform a systematic review and meta-analysis of the benefits and harms of the TJA for thumb CMC OA compared with other treatment strategies.
      Patients and Methods: We performed a systematic search on MEDLINE and CENTRAL databases on August 2, 2023. We included randomized controlled trials investigating the effect of TJA in people with thumb CMC joint OA regardless of the stage or etiology of the disease or comparator. The outcomes were pooled with a random effect meta-analysis.
      Results: We identified 4 studies randomizing 420 participants to TJA or trapeziectomy. At 3 months, TJA's benefits for pain may exceed the clinically important difference. However, after 1-year follow-up TJA does not improve pain compared with trapeziectomy (mean difference 0.53 points on a 0 to 10 scale; 95% confidence interval [CI] 0.26-0.81). Furthermore, it provides a transient benefit in hand function at 3 months (measured with Disabilities of Arm, Shoulder, and Hand questionnaire, scale 0-100, lower is better) compared with trapeziectomy with or without ligament reconstruction tendon interposition. The benefit in function diminished to a clinically unimportant level at 1-year follow-up (4.4 points better; CI 0.42-8.4).
      Conclusion: Transient benefit in hand function for TJA implies that it could be a preferable option over trapeziectomy for people who consider fast postoperative recovery important. However, current evidence fails to inform us if TJA carries long-term higher risks of revisions compared with trapeziectomy.
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    • الموضوع:
      Date Created: 20240618 Date Completed: 20240618 Latest Revision: 20240823
    • الموضوع:
      20250114
    • الرقم المعرف:
      PMC11184324
    • الرقم المعرف:
      10.2340/17453674.2024.40816
    • الرقم المعرف:
      38887076