660 Trapeziectomy Versus Joint Replacement for First Carpometacarpal (CMC-1) Joint Osteoarthritis: A Systematic Review and Meta-Analysis

Abstract Aim The challenge of managing first carpometacarpal (CMC-1) joint osteoarthritis is the lack guidance on which surgical intervention superior. This systematic review and meta-analysis compares replacement (JR) trapeziectomy techniques to provide an update. Method In August 2020, MEDLINE, Embase Web Science were searched for eligible studies that compared these two treatment CMC-1 (PROSPERO registration ID: CRD42020189728). Primary outcomes included Disabilities Arm, Shoulder Hand (DASH), QuickDASH pain visual analogue scale (VAS) scores. Secondary outcomes, such as total complication, dislocation, revision surgery rates, also measured. Results From 1909 identified, 14 (1005 patients) eligible. Our found post-operative score was lower patients in JR group, indicating decreased disability following this technique (5 studies, p = 0.0002). However, VAS scores similar between groups 0.22). Interestingly, had significantly greater odds overall complications (12 studies; OR 2.27; 95% CI 1.17-4.40, 0.02) (9 5.14; 2.06-12.81, 0.0004). Conclusions Overall, based low moderate quality evidence, we treatments may result better function with less comparable scores; however, has requiring surgery. More robust RCTs compare TRAP standardised outcome measures long-term follow-up would add evidence.