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Erschienen in: Wiener klinische Wochenschrift 5-6/2021

30.06.2020 | original article

Efficacy of conservative treatments for hand osteoarthritis

An umbrella review of interventional studies

verfasst von: MD Nicola Veronese, Lee Smith, Francesco Bolzetta, Alberto Cester, Jacopo Demurtas, Leonardo Punzi

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 5-6/2021

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Summary

Background

Hand osteoarthritis (OA) is common, but the efficacy/safety of treatment interventions aimed to improve health outcomes in this population are not well understood. Therefore, the aim of this study was to map and grade the effect of interventions for health outcomes in hand OA.

Methods

Umbrella review of systematic reviews with meta-analyses of randomized controlled trials (RCTs) using placebo/no intervention as control group. For outcomes with a p-value <0.05, the certainty of the evidence was evaluated using the grading of recommendations assessment, development and evaluation (GRADE) assessment.

Results

From 189 abstracts, 9 meta-analyses (24 outcomes) were included, with 8 reporting significant summary results. The use of splints was associated with reduced pain at medium term in thumb carpometacarpal OA (standardized mean difference [SMD] = −0.70; 95% confidence intervals [95% CI]: −1.05 to −0.35; low certainty), reduced pain in long follow-up RCTs in symptomatic hand OA (SMD = −0.80; 95% CI: −1.16; −0.45; moderate certainty), and better function (SMD = 0.42; 95% CI: 0.08; 0.70; low certainty). The use of resistance training (SMD = −0.27; 95% CI: −0.47; −0.07) or physical exercise (SMD = −0.23; 95% CI: −0.42; −0.04) in improving hand pain and in improving finger joint stiffness (SMD = −0.36; 95%CI: −0.58; −0.15) was supported by a moderate certainty of evidence. The use of intra-articular hyaluronic acid in improving function (MD = 1.12; 95% CI: 0.61; 1.64; moderate certainty of evidence) was the only statistically significant pharmacological intervention.

Conclusion

Only some non-pharmacological interventions are effective in improving health outcomes in hand OA and this evidence is supported by a moderate/low certainty, indicating the necessity of further interventional research.

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Metadaten
Titel
Efficacy of conservative treatments for hand osteoarthritis
An umbrella review of interventional studies
verfasst von
MD Nicola Veronese
Lee Smith
Francesco Bolzetta
Alberto Cester
Jacopo Demurtas
Leonardo Punzi
Publikationsdatum
30.06.2020
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 5-6/2021
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-020-01702-0