Analysis of methodological deficiencies of studies reporting surgical outcome following cemented total-joint arthroplasty of trapezio-metacarpal joint of the thumb

Abstract

Cemented total-joint arthroplasty has been increasingly used in the treatment of end stage arthritis of the thumb trapeziometacarpal joint. Evidence supporting its use in the treatment of trapeziometacarpal disorders in the literature is very limited. Most hand surgeons agree that there are concerns about the methodological quality of the limited literature available. In this study, we analysed the methodological quality of the outcome studies on cemented total-joint arthroplasty of the thumb. We included all the outcome studies published in the English literature on cemented total-joint arthroplasty of the trapeziometacarpal joint of thumb. We analysed these studies for methodological deficiencies and quality of outcome reporting based on the recommendations given by Coleman et al. Our study revealed that there were no uniform standards of outcome reporting. The mean Coleman score for the studies dealing with cemented total-joint arthroplasty of the thumb was 42.9. Major deficiencies were identified in areas like subject selection criteria (0/15), type of study (5.7/15), description of surgical procedure (3.7/5), description of the rehabilitation protocol (2/10), outcome measures (4.4/10) and outcome assessment (3.9/15). The methodological quality of the studies published within the last 10 years (49.9±9.7) was found to be slightly better than the studies published over 10 years ago (39.7±7.8). Our study highlights the need for more evidence in the form of randomised controlled prospective studies conducted with good methodological quality, comparing the cemented total-joint arthroplasty of the thumb to other procedures available for the treatment of disorders of the thumb. Further, to improve the standards of reporting, journal editors should try to standardise the outcome of the reporting by following the surgical procedures on the thumb.Résumé L'usage des prothèses totales cimentées dans le traitement des arthroses sévères trapézométarcarpiennes est en augmentation. Les preuves en faveur de cette utilisation sont rares. La plupart des chirurgiens de la main s'accordent à dire que les études de la littérature ont une méthodologie douteuse. Nous avons analysé dans cette étude la qualité méthodologique de la littérature pour les arthroplasties cimentées. Nous avons inclus pour cette étude tous les résultats publiés dans la littérature anglo-saxonne pour ce type de prothèses. Nous avons étudié les méthodologies et la qualité des résultats selon les recommandations de Coleman et al. Notre étude nous permet de montrer qu'il n'y a pas de standard uniforme pour valider ces résultats. Le score de Coleman et al. dans ces études a été de 42.9 (déviation standard [SD]-9.4). Les problèmes principaux que nous avons identifiés reposent sur les critères de sélection (0/15), le type d'études (5.7/15), la description du traitement chirurgical (3.7/5), la description du protocole de rééducation (2/10), les mesures de surveillance (4.4/10) et le devenir des patients (3.9/15). Pour la qualité méthod-International Orthop...

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