Trapeziometacarpal Osteoarthritis. Conservative and Surgical Treatment. A Diagnostic-Therapeutic Algorithm.

Abstract

Trapeziometacarpal osteoarthritis (carpometacarpal arthritis / CMC-1 arthritis) is a common cause of chronic thumb pain and may significantly worsen patients' quality of life. The thumb is the most important digit of the hand. A diagnostic-therapeutic algorithm for CMC-1 arthritis should be widely known and based on up-to-date evidence-based medical knowledge. The literature describes many medical and surgical treatment approaches. The methods used vary between hospitals and clinics. They also depend on patients' financial capabilities and many other factors.Medical (conservative) treatment appears to be effective in 60% of cases, in particular when the synergy of combining several treatment methods is taken advantage of. The most commonly performed surgical procedures in CMC-1 arthritis fall into two major groups, namely trapeziectomy or arthroplasty. However, there is no proof of superiority of one surgical treatment method over the others, and all of them have their advantages and disadvantages.This paper aims to present the most up-to-date knowledge about: (1) conservative and (2) surgical treatments for CMC-1 arthritis and (3) to propose a diagnostic-therapeutic algorithm for this condition. It is based on the latest literature (mainly works published in the last 5 years) acquired from databases such as PubMed, Clinical Key and Science Direct. The article is the second of a two-part series that presents a diagnostic-therapeutic algorithm for CMC-1 arthritis. The authors believe that it may contribute to broadening knowledge about CMC-1 arthritis, optimizing the therapeutic process and improving care for patients with CMC-1 arthritis in Poland.