This meta-analysis focused on finding out the most suitable option among orthoses in patients with osteoarthritis (OA) of the thumb.
After comparison of five treatments in this meta-analysis, the
results recommend an initial treatment using a long rigid orthosis and later,
short rigid orthosis. The SUCRA score revealed that the long rigid splint is
the best choice for pain relief, while the stiff short splint is the best
option for decreasing disability.
This meta-analysis focused on finding out
the most suitable option
among orthoses in patients with osteoarthritis (OA) of the thumb.
Database
search included exploring the Embase, Cochrane, Cochrane, ClinicalTrials.gov and
PubMed. The randomized controlled trials involving thumb OA concerning any
orthosis from the beginning were included. Independent reviewers extracted the
data and examined for accuracy and completeness. Pain and function were
regarded as the outcomes. Random-effects model was useful for the direct
pair-wise associations.
A total of 619 patients in 11 RCT’s were considered.
Five groups were assessed for 4 diverse orthoses,
namely:
As per the results, all splints were found to
be superior to placebo in terms of easing pain intensity and the top-ranked
intervention was the Rigid CMC-MCP with a SUCRA (surface under the cumulative
ranking curve analysis) score of 65.4. A SUCRA score of 71.6 was reported based
on the function assessment.
Long thermoplastic splint was a found to be the preeminent
choice for pain relief and the short thermoplastic carpometacarpal splint can
be regarded as the most appropriate treatment to increase function.
Archieves of Physical Medicine and Rehabilitation
Comparative Effectiveness of Orthoses for thumb osteoarthritis: A Systematic Review and Network Meta-Analysis
Nicola Marotta et al.
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