OBJECTIVE: To provide an overview of rehabilitation for patients who underwent CMC-1 arthroplasty, with emphasis on early active mobilization. DATA SOURCES/STUDY SELECTION: PubMed/Medline, Embase, CINAHL and Cochrane were searched for articles written in English that described postoperative regime (including immobilization period/method and/or description of exercises/physical therapy, follow-up >= six weeks) on CMC-1 arthroplasty. DATA EXTRACTION: The PRISMA statement was used as guidance in this review and methodological quality was assessed using the Effective Public Health Practice Project quality assessment tool. Randomized studies were additionally scored using the Physiotherapy Evidence Database scale. DATA SYNTHESIS: Twenty-seven studies were included, concerning 1,015 participants in whom 1,118 surgical procedures were performed. A summary on the components of postoperative rehabilitation used in the included studies on CMC-1 OA is presented for different surgical interventions. We found that early active recovery (including short immobilization, early initiation of ROM and strength exercises) provides positive outcomes on pain, limitations in ADL and grip and pinch strength, but comparative studies are lacking. Furthermore, three postoperative exercises/therapy phases were identified in the literature: the 'acute phase', the 'unloaded phase' and the 'functional phase', but again comparative studies are lacking. CONCLUSIONS: Early active recovery is used more often in the literature and does not lead to worse outcomes or more complications. This systematic review provides guidance for clinicians in the content of postoperative rehabilitation on CMC-1 arthroplasty. The review also clearly identifies the almost complete lack of high quality, comparative studies on postoperative rehabilitation after CMC-1 arthroplasty.

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