The effects of non-surgical and non-pharmacological treatment of patients with hand osteoarthritis


Treatment of hand OA aims to reduce pain, functional disability, and to optimize hand function. There are many ways to treat hand OA. But so far it is unclear which conservative therapy is most beneficial. Earlier RCTs found discrepancies in the effect of non-surgical and non-pharmacological interventions on pain and physical function. The identification of subgroups of patients that are responsive to non-surgical and non-pharmacological interventions for hand OA will help future clinical decision making. Therefore, this project aims to identify subgroups of patients with hand OA that will most benefit from non-surgical and non-pharmacological treatment by collecting individual patient data (IPD) from existing RCTs.


IPD will be retrieved from published RCTs on non-surgical and non- pharmacological treatment of hand OA to conduct meta-analyses. We will include any intervention except pharmacological and surgical treatment. Our primary outcome is pain. Secondary outcome is physical function, if available. Possible subgroups include age, sex, BMI, hypermobility and other comorbidities, medication, occupation, baseline pain, radiological severity of OA, duration of symptoms

A two-stage approach of IPD analyses will be performed. In the first stage all IPD from each trial is analyzed separately to obtain aggregate data of effect estimates of interest. Then, in the second stage data is synthesized to produce summary meta-analysis results based on a random effect model.


Data collection in process.

Protocol and publications


M. (Marienke) van Middelkoop 1
G. (Giesleen) Thissen 1
J. (Joost) Colaris 2
R. (Ruud) Selles 3
S. (Sita) M.A. Bierma-Zeinstra 1

1. Erasmus MC Medical University Center Rotterdam, Department of General Practice, The Netherlands
2. Erasmus MC Medical University Center Rotterdam, Department of Orthopaedic Surgery, The Netherlands
3. Erasmus MC Medical University Center Rotterdam, Department of Plastic, Reconstructive and Hand Surgery, The Netherlands