04 April 2024
Published in December 2023
"Evidence-based Management of Adults with Thumb Base Osteoarthritis," provides comprehensive insights into the optimal approaches for managing osteoarthritis at the thumb base in adults. Authored by experts in the field, the document delves into evidence-based strategies, encompassing diagnosis, treatment, and rehabilitation. It offers a thorough examination of current research findings, clinical guidelines, and therapeutic interventions tailored to address the unique challenges posed by thumb base osteoarthritis. Healthcare professionals, researchers, and practitioners seeking authoritative guidance on evidence-based management for this specific condition will find this document to be a valuable and informative resource.
Evidence-based Management of Thumb Base Osteoarthritis
by Soham Gangopadhyay, Matthew Gardiner, Wee Sim Kor, Daniel Burchette, Victoria Jansen, Helen McKenna.
"Thumb base osteoarthritis (TBOA) is a common condition and it is generally agreed that initial management should be non-surgical, followed by surgery if needed. However, the provision and components of non-surgical treatment and choice of surgery remains variable across the country.
Treatment of hand and wrist osteoarthritis is one of the top 10 priorities established by the James Lind Alliance Priority Setting Partnership. As such, we set out to provide an overview of the best available evidence for non-surgical and surgical management of TBOA in the United Kingdom and suggest a pathway for treatment of this condition. We followed the recommendations set out in the BEST Guidelines process manual [British Society for Surgery of the Hand (BSSH) Evidence for Surgical Treatment (B.E.S.T.)], accredited by NICE. A guideline development group (GDG) was formed comprising of orthopaedic and plastic surgery consultants and trainees and hand therapists (physiotherapy and occupational therapy). We performed a systematic review of RCTs on management options for thumb base osteoarthritis (TBOA). Management was divided into non-invasive treatment, joint injection, and surgery. The results indicated that the treatment of thumb base osteoarthritis should follow a step-wise approach, starting with non-surgical measures with low risk of harm before progressing to more invasive and complex treatments if pain and dysfunction continues.
The evidence from our systematic review is presented in the form of clinical recommendations for practice in a number of user-friendly formats including a patient flow algorithm and a quick reference tool that links into various resources to guide clinicians and patients dealing with TBOA."
Soham Gangopadhyay
Read the guidelines in full: Evidence-based Management of Adults with Thumb Base Osteoarthritis
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