Intra-articular injections in thumb osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

Trellu, Sabine; Dadoun, Sabrina; Bérenbaum, Francis; Fautrel, Bruno; Gossec, Laure

doi:10.1016/j.jbspin.2015.02.002

Cited by 43 publications

(34 citation statements)

References 25 publications

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“…A slightly different position in terms of applying HA is presented by the ACR, whose guidelines do not recommend applying HA and corticosteroids in OA of MCP joints due to the insufficient amount of evidence proving effectiveness of these specimens [65]. Some of the research highlights the wider importance of HA in improving the functionality of affected joints and the more significant role of CST in reducing pain [66]. It should be noted that at the moment there are no studies showing the significance of acid injection with different molecular weights in the discussed joint [67].…”

Section: The Role Of Hyaluronic Acid In Degenerative Arthritis Treatmentmentioning

confidence: 99%

Viscosupplementation in prevention and treatment of the degenerative joint disease

Kotela¹,

Sarzyńska²,

Woźniak³

et al. 2015

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Osteoarthritis (OA) is one of the most common musculoskeletal disorders. It limits patients' functionality and life satisfaction significantly. Although there are numerous types of therapy, the success rate of conservative treatment is limited, and it is often necessary to introduce surgical treatment. Therefore, new effective methods of therapy for OA are being tested and submitted. Endogenous hyaluronic acid (HA) is a natural ingredient of many tissues in the human organism, including synovial fluid. Viscosupplementation with the usage of HA is a relatively new method for treating degenerative joint changes. By virtue of its good safety profile and simplicity of application, it is increasingly used as an alternative or addition to classic conservative treatment. In this work, we attempted to summarise the current state of knowledge of HA usage in OA treatment based on literature. StreszczenieChoroba zwyrodnieniowa stawów jest częstym schorzeniem układu mięśniowo-szkieletowego. Niestety skuteczność leczenia zachowawczego zmian zwyrodnieniowych stawów jest ograniczona i często konieczne bywa leczenie chirurgiczne. W związku z tym podejmowane są próby wprowadzenia nowych metod terapii choroby zwyrodnieniowej stawów. Endogenny kwas hialuronowy jest naturalnym składnikiem wielu tkanek w organizmie ludzkim, w tym płynu stawowego. Wiskosuplementacja z wykorzystaniem preparatów kwasu hialuronowego jest stosunkowo nową metodą miejscowego leczenia zmian zwyrodnieniowych. Ze względu na dobry profil bezpieczeństwa i łatwość aplikacji jest coraz częściej wykorzystywana jako alternatywa lub wzbogacenie klasycznych terapii zachowawczych. W pracy podjęto próbę podsumowania aktualnej wiedzy na temat stosowania kwasu hialuronowego w leczeniu zmian zwyrodnieniowych stawów na podstawie aktualnego piśmiennictwa.

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Section: The Role Of Hyaluronic Acid In Degenerative Arthritis Treatmentmentioning

confidence: 99%

Viscosupplementation in prevention and treatment of the degenerative joint disease

Kotela¹,

Sarzyńska²,

Woźniak³

et al. 2015

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“…Despite the prevalence of thumb carpometacarpal osteoarthritis (TCMC-OA), there is a distinct lack of robust clinical effectiveness studies into conservative interventions on this condition. Recent systematic reviews for the management of TCMC-OA have identified a notable paucity of clinical trials to guide recommendations for clinicians treating this disease and underlined a pressing need for well-designed studies to promote new therapeutic choices (Bertozzi et al, 2015;Hamasaki et al, 2015;Trellu, Dadoun, Berenbaum, Fautrel, & Gossec, 2015).…”

Section: Introductionmentioning

confidence: 99%

Class IV laser therapy for trapeziometacarpal joint osteoarthritis: Study protocol for a randomized placebo‐controlled trial

Medina-Porqueres

Cantero‐Téllez

2018

Physiotherapy Res Intl

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“…The same review found evidence that hand exercises might improve grip strength and hand function; however, evidence was based on individual trials using different exercise programmes. With regard to pharmacological management, there are insufficient data available to support the efficacy of intra-articular therapy with either corticosteroids or hyaluronic acid15 and their use is not recommended by the 2012 American College of Rheumatology (ACR) guidelines 16. On the other hand, non-steroidal anti-inflammatory drugs (NSAIDs) are recommended to relieve pain associated with thumb base OA, and topical formulations are recommended over oral NSAIDs in the most recent guidelines, due to a superior safety profile 16–18.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of combined conservative therapies on clinical outcomes in patients with thumb base osteoarthritis: protocol for a randomised, controlled trial (COMBO)

et al. 2017

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IntroductionManagement of thumb base osteoarthritis (OA) using a combination of therapies is common in clinical practice; however, evidence for the efficacy of this approach is lacking. The aim of this study is to determine the effect of a combination of conservative therapies for the treatment of thumb base OA compared with an education control group.Methods and analysisThis is a randomised, controlled, single-centre, two-arm superiority trial with 1:1 allocation ratio; with assessor and statistician blinded. Participants are blinded to the trial's hypothesis and to the interventions received by the opposite group. A total of 204 participants will be recruited from the community and randomised using a computer-generated schedule. The intervention group will receive education for joint protection and OA, a splint for the base of the thumb, hand exercises and topical diclofenac sodium 1% gel over 6 weeks. The control group will receive education for joint protection and OA alone. Main inclusion criteria are pain ≥40 mm (Visual Analogue Scale, 0–100) at the base of the thumb, impairment in hand function ≥6 (Functional Index for Hand Osteoarthritis, 0–30) and radiographic thumb base OA (Kellgren Lawrence grade ≥2). Participants currently receiving any of the intervention components will be excluded. Outcomes will be measured at 2, 6 and 12 weeks. The primary outcome is change in pain and hand function from baseline to 6 weeks. Other outcomes include changes in grip and pinch strength, quality of life, presence of joint swelling and tenderness, duration of joint stiffness, patient's global assessment and use of rescue medication. Analysis will be performed according to the intention-to-treat principle. Adverse events will be monitored throughout the study.Ethics and disseminationThis protocol is approved by the local ethics committee (HREC/15/HAWKE/479). Dissemination will occur through presentations at international conferences and publication in peer-reviewed journals.Trial registration numberACTRN12616000353493; Pre-results.

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Intra-articular injections in thumb osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

Abstract: This meta-analysis shows great heterogeneity. Hyaluronic acid may be useful to increase functional capacity and corticosteroids to decrease pain in thumb osteoarthritis at week 24.

Cited by 43 publications

References 25 publications

Viscosupplementation in prevention and treatment of the degenerative joint disease

Viscosupplementation in prevention and treatment of the degenerative joint disease

Class IV laser therapy for trapeziometacarpal joint osteoarthritis: Study protocol for a randomized placebo‐controlled trial

Efficacy of combined conservative therapies on clinical outcomes in patients with thumb base osteoarthritis: protocol for a randomised, controlled trial (COMBO)

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