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For thumb base osteoarthritis,
splints may not add any extra benefit.
A study published in “Rheumatology” portrays that there is no extra advantage of the addition of a thumb splint to supportive and high-quality self-management programme for thumb osteoarthritis offered by clinicians.
A pragmatic, parallel-group, multicentre, randomized controlled trial was carried out to explore the efficacy, clinical effectiveness, and cost-effectiveness of splints (orthoses) in individuals suffering from symptomatic basal thumb joint osteoarthritis and having at least moderate hand pain and dysfunction.
Utilizing a computer-based minimization system, 349 patients were randomly assigned (1:1:1) to one of the three treatment arms: (i) a therapist supported self-management programme (SSM, n=116), (ii) a therapist aided self-management programme and a placebo thumb splint (SSM+PS, n=117) (iii) a therapist aided self-management programme and a verum thumb splint (SSM+S, n=116).
The subjects were blinded to arm randomization, were given 90 min treatment over 8 weeks, and were monitored for 12 weeks from baseline. The primary outcome parameter was Australian/Canadian (AUSCAN) hand pain at eight weeks ascertained utilizing the intention to treat analysis. The costs of therapy were estimated.
At 8 weeks, 292 (84%) subjects offered AUSCAN Osteoarthritis Hand Index hand pain scores. All the cohorts improved, with no mean treatment difference between the cohorts, as shown in the following table:
The average 12-week costs were: (i)
SSM £586; (ii) SSM+S £738; and (iii) SSM+PS £685. Thus, no additional advantage
of using splints for thumb base osteoarthritis is witnessed.
Rheumatology
The clinical and cost effectiveness of splints for thumb base osteoarthritis: a randomized controlled clinical trial
Jo Adams et al.
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