A Systematic Review of Non-Surgical Therapies for Osteoarthritis of the Hand

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A Systematic Review of Non-Surgical Therapies for Osteoarthritis of the Hand
Key Take-Away: 

This systematic review provides an update on the different non-surgical therapies that can be beneficial for patients with osteoarthritis.

Osteoarthritis is a degenerative joint disorder that can affect wrist, basilar joint connecting thumb & wrist, fingertips and middle knuckles of fingers of your hand. 

ABSTRACT: 
Background: 

Osteoarthritis is a degenerative joint disorder that can affect wrist, basilar joint connecting thumb & wrist, fingertips and middle knuckles of fingers of your hand.

The objective of the study was to update the earlier systematic reviews evaluating all published randomized controlled trials (RCTs) assessing pharmacological and non-pharmacological therapies in patients with hand osteoarthritis (OA). Surgical therapies were not evaluated.

Methods: 

RCTs published between March 2008 and December 2015 were added to the previous systematic reviews.

Results: 

A total of 95 RCTs evaluating various pharmacological and non-pharmacological therapies in hand OA were analyzed. The methodological quality of these RCTs was found to be improved since the last update, with more studies describing their methods for randomization, blinding, and allocation concealment.

However, RCTs continue to be weakened by a lack of consistent case definition and a lack of standardized outcome assessments specific to hand OA. The number and location of evaluated hand joints continue to be underreported, and only 25% of RCTs adequately described the method used to ensure allocation concealment. These remain a major weakness of published RCTs. A meta-analysis could not be performed because of marked study heterogeneity, insufficient statistical data available in the published RCTs, and a small number of identical comparators.

Conclusion: 

Hand OA is a complex area to study the efficacy of therapies. An improvement in the overall design and conduct of RCTs was seen; however, additional large RCTs with a more robust methodological approach specific to hand OA are warranted to make clinically accurate conclusions about the efficacy of various treatment regimens available.

 

Source:

 Osteoarthritis and Cartilage

Link to the source:

http://www.oarsijournal.com/article/S1063-4584(17)31028-2/fulltext?rss=yes

The original title of the article:

Systematic review of non-surgical therapies for osteoarthritis of the hand: an update

Authors:

S. Lue et al.

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