No cure for hand OA is known yet, but treatment aims to reduce pain, functional disability and to optimize hand function. For patients whose pain and disability are persistent, surgical intervention becomes an option. In the last decades, a variety of surgical interventions on the affected joints have been described for patients who suffer from hand OA. However, we still do not know which surgical technique is most beneficial. Identifying subgroups of patients that are more likely to have a beneficial effect a certain intervention could improve clinical decision making in hand surgery for the individual patient. The aim of this study is to identify subgroups of patients with hand OA that will most benefit from surgical treatment of the affected joints by collecting individual patient data (IPD) from existing RCTs.
IPD will be retrieved from published RCTs on surgical interventions of osteoarthritic joints of the hand to conduct meta-analyses. We will include any surgical intervention. Our primary outcome is pain, and our secondary outcomes are patient reported outcome measures as DASH, MHQ, FIHOA and PRWE, but not exclusive. Possible subgroups include age, sex, BMI, hypermobility and other comorbidities, use of tobacco, occupation, radiological severity of OA, degree of anxiety/depression, duration of symptoms and affected joint(s).
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.