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Reduction in the need for operation after conservative treatment of osteoarthritis of the first carpometacarpal joint: a seven year prospective study
Berggren M, Joost-Davidsson A, Lindstrand J, Nylander G, Povlsen B
Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 2001 Dec;35(4):415-417
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The effect of occupational therapy for patients awaiting surgery for isolated osteoarthritis of the carpometacarpal joint of the thumb was assessed. Thirty-three patients awaiting joint replacement because of pain were randomised into three groups. One group was treated with technical accessories, two other groups had in addition one of two types of splints, and all patients received extensive advice on how to accommodate activities of daily living. They all had an initial seven months' trial on this regimen at which time 23/33 (70%) no longer required an operation. During the following seven years four patients died, but only two of the remaining 19 patients wanted an operation. We therefore recommend that patients with osteoarthritis of the carpometacarpal joint of the thumb are offered a similar programme in addition to access to accessories and splints preoperatively.

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