1511 A Review of Non-Surgical Management of Hand Osteoarthritis. (12th October 2021)

• Record Type: Journal Article
• Authors: Shah, J
• Is Part Of: British journal of surgery. Volume 108:Supplement 6(2021)
• Publication Date: 2021-10-12
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab259.732
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Introduction: Hand osteoarthritis (OA) is a common musculoskeletal condition leading to pain and loss of function. Current treatment aims to target the symptoms of hand OA involving a combination of non-surgical and surgical interventions. During the COVID-19 pandemic, there has been a renewed interest in conservative management. The purpose of this article is to review non-surgical therapies in hand OA, their mechanism of action and efficacy. Method: An online search of PubMed for articles between 1 st January 2004- 1 st February 2020 was performed according to specific terms and agreed inclusion criteria. Results: The search produced 289 results of which 28 met the inclusion criteria comprising 13 RCTs, 8 systematic reviews, 5 clinical trials and 2 international guidelines. Conclusions: Topical NSAIDs remain first-line pharmacological agents in the management of hand OA. Increasingly, oral NSAIDs have been recommended however their use must be balanced against their potential adverse effects. Supplementation with chondroitin sulfate may help to delay the structural damage in hand OA, which may reduce the need for oral NSAIDs. Intra-articular injections of hyaluronic acid and corticosteroids are effective treatments and provide longer symptomatic relief, additionally hyaluronic acid may improve function over a longer period of time. Targeted hand exercises are widely recommended however may only provide short-term improvements and vary according to the different subtypes of hand OA. In summary, there are multiple conservative management options for hand OA which should be considered prior to operative intervention given the current restrictions on surgical practice.