Skip to main content
Top
Published in: HAND 4/2015

01-12-2015 | Review

Intra-articular corticosteroid injections to manage trapeziometacarpal osteoarthritis—a systematic review

Authors: A. Fowler, M. G. Swindells, F. D. Burke

Published in: HAND | Issue 4/2015

Login to get access

Abstract

Background

Osteoarthritis of the trapeziometacarpal joint (TMJ) is a common condition causing significant disability. The aim of this study is to ascertain whether an intra-articular corticosteroid injection leads to pain relief and increased function and what is the duration and magnitude of this effect.

Methods

A systematic review with a critical appraisal of identified studies that met the inclusion criteria was performed. Two authors performed the literature review by independently searching the Cochrane, PubMed and Google Scholar databases.

Results

A total of 118 relevant articles were found, but only nine studies met the inclusion criteria which included 4 double-blinded randomised control trials (RCTs) and 5 prospective case series. There is some evidence in the literature to support the efficacy of steroid injections into the TMJ. Most studies do suggest a good short-term benefit. However, one identifies no benefit over placebo but two studies found a benefit lasting at least 6 months.

Conclusions

This study demonstrates that there are potentially significant although short-term benefits to be gained from steroid injections into the TMJ. They can lead to pain relief and improved function, certainly in the first 1 to 3 months post-injection. Steroid injections are a low-risk procedure and are helpful in delaying or avoiding the need for surgery.
Literature
1.
go back to reference Armstrong AL, Hunter JB, Davis TR. The prevalence of degenerative arthritis of the base of the thumb in post-menopausal women. J Hand Surg (Br). 1994;19(3):340–1.CrossRef Armstrong AL, Hunter JB, Davis TR. The prevalence of degenerative arthritis of the base of the thumb in post-menopausal women. J Hand Surg (Br). 1994;19(3):340–1.CrossRef
2.
go back to reference Bahadir C, Onal B, Dayan VY, Gürer N. Comparison of therapeutic effects of sodium hyaluronate and corticosteroid injections on trapeziometacarpal joint osteoarthritis. Clin Rheumatol. 2009;28(5):529–33.CrossRefPubMed Bahadir C, Onal B, Dayan VY, Gürer N. Comparison of therapeutic effects of sodium hyaluronate and corticosteroid injections on trapeziometacarpal joint osteoarthritis. Clin Rheumatol. 2009;28(5):529–33.CrossRefPubMed
3.
go back to reference Caldwell JR. Intra-articular corticosteroids. Guide to selection and indications for use. Drugs. 1996;52(4):507–14.CrossRefPubMed Caldwell JR. Intra-articular corticosteroids. Guide to selection and indications for use. Drugs. 1996;52(4):507–14.CrossRefPubMed
4.
go back to reference Cochrane review: conservative therapy for thumb (trapeziometacarpal joint) osteoarthritis. Stage: registered title; date of creation: 10. 2009; last updated: 2. March 2010; Entity: musculoskeletal group. Cochrane review: conservative therapy for thumb (trapeziometacarpal joint) osteoarthritis. Stage: registered title; date of creation: 10. 2009; last updated: 2. March 2010; Entity: musculoskeletal group.
5.
go back to reference Day CS, Gelberman R, Patel AA, Vogt MT, Ditsios K, Boyer MI. Basal joint osteoarthritis of the thumb: a prospective trial of steroid injection and splinting. J Hand Surg [Am]. 2004;29(2):247–51.CrossRef Day CS, Gelberman R, Patel AA, Vogt MT, Ditsios K, Boyer MI. Basal joint osteoarthritis of the thumb: a prospective trial of steroid injection and splinting. J Hand Surg [Am]. 2004;29(2):247–51.CrossRef
6.
go back to reference Dell PC, Brushart TM, Smith RJ. Treatment of trapeziometacarpal arthritis: results of resection arthroplasty. J Hand Surg [Am]. 1978;3(3):243–9.CrossRef Dell PC, Brushart TM, Smith RJ. Treatment of trapeziometacarpal arthritis: results of resection arthroplasty. J Hand Surg [Am]. 1978;3(3):243–9.CrossRef
7.
go back to reference De Smet L. Responsiveness of the DASH score in surgically treated basal joint arthritis of the thumb: preliminary results. Clin Rheumatol. 2004;23:223–4.CrossRefPubMed De Smet L. Responsiveness of the DASH score in surgically treated basal joint arthritis of the thumb: preliminary results. Clin Rheumatol. 2004;23:223–4.CrossRefPubMed
8.
go back to reference Eaton RG, Lane LB, Littler JW, Keyser JJ. Ligament reconstruction for the painful thumb carpometacarpal joint: a long-term assessment. J Hand Surg [Am]. 1984;9(5):692–9.CrossRef Eaton RG, Lane LB, Littler JW, Keyser JJ. Ligament reconstruction for the painful thumb carpometacarpal joint: a long-term assessment. J Hand Surg [Am]. 1984;9(5):692–9.CrossRef
9.
go back to reference Harrison J, Fahmy N. (ii) Management of peri-trapezial osteoarthritis. Curr Orthop. 2005;19(3):190–5.CrossRef Harrison J, Fahmy N. (ii) Management of peri-trapezial osteoarthritis. Curr Orthop. 2005;19(3):190–5.CrossRef
10.
go back to reference Helm AT, Higgins G, Rajkumar P, Redfern DR. Accuracy of intra-articular injections for osteoarthritis of the trapeziometacarpal joint. Int J Clin Pract. 2003;57(4):265–6.PubMed Helm AT, Higgins G, Rajkumar P, Redfern DR. Accuracy of intra-articular injections for osteoarthritis of the trapeziometacarpal joint. Int J Clin Pract. 2003;57(4):265–6.PubMed
11.
go back to reference Heyworth BE, Lee JH, Kim PD, Lipton CB, Strauch RJ, Rosenwasser MP. Hylan versus corticosteroid versus placebo for treatment of basal joint arthritis: a prospective, randomized, double-blinded clinical trial. J Hand Surg [Am]. 2008;33(1):40–8.CrossRef Heyworth BE, Lee JH, Kim PD, Lipton CB, Strauch RJ, Rosenwasser MP. Hylan versus corticosteroid versus placebo for treatment of basal joint arthritis: a prospective, randomized, double-blinded clinical trial. J Hand Surg [Am]. 2008;33(1):40–8.CrossRef
12.
go back to reference Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29(6):602–8.CrossRefPubMed Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29(6):602–8.CrossRefPubMed
13.
go back to reference Joshi R. Intraarticular corticosteroid injection for first carpometacarpal osteoarthritis. J Rheumatol. 2005;32(7):1305–6.PubMed Joshi R. Intraarticular corticosteroid injection for first carpometacarpal osteoarthritis. J Rheumatol. 2005;32(7):1305–6.PubMed
14.
go back to reference Kenniston JA, Bozentka DJ. Treatment of advanced carpometacarpal joint disease: arthrodesis. Hand Clin. 2008;24(3):285–94.CrossRefPubMed Kenniston JA, Bozentka DJ. Treatment of advanced carpometacarpal joint disease: arthrodesis. Hand Clin. 2008;24(3):285–94.CrossRefPubMed
15.
go back to reference Khan M, Waseem M, Raza A, Derham D. Quantitative assessment of improvement with single corticosteroid injection in thumb CMC joint osteoarthritis? Open Orthop J. 2009;19(3):48–51.CrossRef Khan M, Waseem M, Raza A, Derham D. Quantitative assessment of improvement with single corticosteroid injection in thumb CMC joint osteoarthritis? Open Orthop J. 2009;19(3):48–51.CrossRef
16.
go back to reference Kumar N, Newman RJ. Complications of intra- and peri-articular steroid injections. Br J Gen Pract. 1999;49(443):465–6.PubMedCentralPubMed Kumar N, Newman RJ. Complications of intra- and peri-articular steroid injections. Br J Gen Pract. 1999;49(443):465–6.PubMedCentralPubMed
17.
go back to reference Maarse W, Watts AC, Bain GI. Medium-term outcome following intra-articular corticosteroid injection in first cmc joint arthritis using fluoroscopy. Hand Surg. 2009;14(2–3):99–104.CrossRefPubMed Maarse W, Watts AC, Bain GI. Medium-term outcome following intra-articular corticosteroid injection in first cmc joint arthritis using fluoroscopy. Hand Surg. 2009;14(2–3):99–104.CrossRefPubMed
18.
go back to reference Mandl LA, Hotchkiss RN, Adler RS, Ariola LA, Katz JN. Can the carpometacarpal joint be injected accurately in the office setting? Implications for therapy. J Rheumatol. 2006;33(6):1137–9.PubMed Mandl LA, Hotchkiss RN, Adler RS, Ariola LA, Katz JN. Can the carpometacarpal joint be injected accurately in the office setting? Implications for therapy. J Rheumatol. 2006;33(6):1137–9.PubMed
20.
go back to reference Meenagh GK, Patton J, Kynes C, Wright GD. A randomised controlled trial of intra-articular corticosteroid injection of the carpometacarpal joint of the thumb in osteoarthritis. Ann Rheum Dis. 2004;63(10):1260–3.PubMedCentralCrossRefPubMed Meenagh GK, Patton J, Kynes C, Wright GD. A randomised controlled trial of intra-articular corticosteroid injection of the carpometacarpal joint of the thumb in osteoarthritis. Ann Rheum Dis. 2004;63(10):1260–3.PubMedCentralCrossRefPubMed
21.
go back to reference Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trial. BMJ. 2010;340:c869.PubMedCentralCrossRefPubMed Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trial. BMJ. 2010;340:c869.PubMedCentralCrossRefPubMed
22.
go back to reference Newman RJ. Local skin depigmentation due to corticosteroid injection. Br Med J (Clin Red Ed). 1984;288(6432):1725–6.CrossRef Newman RJ. Local skin depigmentation due to corticosteroid injection. Br Med J (Clin Red Ed). 1984;288(6432):1725–6.CrossRef
23.
go back to reference Oxford Centre for Evidence Based Medicine—Levels of Evidence (2009). Produced by Bob Phillips, Chris Ball, Dave Sackett, Doug Badenoch, Sharon Straus, Brian Haynes, Martin Dawes since November 1998. Updated by Jeremy Howick,. Oxford Centre for Evidence Based Medicine—Levels of Evidence (2009). Produced by Bob Phillips, Chris Ball, Dave Sackett, Doug Badenoch, Sharon Straus, Brian Haynes, Martin Dawes since November 1998. Updated by Jeremy Howick,.
24.
go back to reference Pendse A, Nisar A, Shah SZ, Bhosale A, Freeman JV, Chakrabarti I. Surface replacement trapeziometacarpal joint arthroplasty—early results. J Hand Surg Eur. 2009;34(6):748–57.CrossRef Pendse A, Nisar A, Shah SZ, Bhosale A, Freeman JV, Chakrabarti I. Surface replacement trapeziometacarpal joint arthroplasty—early results. J Hand Surg Eur. 2009;34(6):748–57.CrossRef
25.
go back to reference Pollard MA, Cermak MB, Buck WR, Williams DP. Accuracy of injection into the basal joint of the thumb. Am J Orthop (Belle Mead NJ). 2007;36(4):204–6. Pollard MA, Cermak MB, Buck WR, Williams DP. Accuracy of injection into the basal joint of the thumb. Am J Orthop (Belle Mead NJ). 2007;36(4):204–6.
27.
go back to reference Rogojan C, Hetland ML. Depigmentation—a rare side effect to intra-articular glucocorticoid treatment. Clin Rheumatol. 2004;23(4):373–5.CrossRefPubMed Rogojan C, Hetland ML. Depigmentation—a rare side effect to intra-articular glucocorticoid treatment. Clin Rheumatol. 2004;23(4):373–5.CrossRefPubMed
28.
go back to reference Schulz KF, Altman DG, Moher D, for the CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332.PubMedCentralCrossRefPubMed Schulz KF, Altman DG, Moher D, for the CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332.PubMedCentralCrossRefPubMed
29.
go back to reference Sodha S, Ring D, Zurakowski D, Jupiter JB. Prevalence of osteoarthrosis of the trapeziometacarpal joint. J Bone Joint Surg Am. 2005;87(12):2614–8.CrossRefPubMed Sodha S, Ring D, Zurakowski D, Jupiter JB. Prevalence of osteoarthrosis of the trapeziometacarpal joint. J Bone Joint Surg Am. 2005;87(12):2614–8.CrossRefPubMed
30.
go back to reference Stahl S, Karsh-Zafrir I, Ratzon N, Rosenberg N. Comparison of intraarticular injection of depot corticosteroid and hyaluronic acid for treatment of degenerative trapeziometacarpal joints. J Clin Rheumatol. 2005;11(6):299–302.CrossRefPubMed Stahl S, Karsh-Zafrir I, Ratzon N, Rosenberg N. Comparison of intraarticular injection of depot corticosteroid and hyaluronic acid for treatment of degenerative trapeziometacarpal joints. J Clin Rheumatol. 2005;11(6):299–302.CrossRefPubMed
31.
go back to reference Stefanich RJ. Intraarticular corticosteroids in treatment of osteoarthritis. Orthop Rev. 1986;15(2):65–71.PubMed Stefanich RJ. Intraarticular corticosteroids in treatment of osteoarthritis. Orthop Rev. 1986;15(2):65–71.PubMed
32.
go back to reference Swindells MG, Logan AJ, Armstrong DJ, Chan P, Burke FD, Lindau TR. The benefit of radiologically-guided steroid injections for trapeziometacarpal osteoarthritis. Ann R Coll Surg Engl. 2010;92(8):680–4.PubMedCentralCrossRefPubMed Swindells MG, Logan AJ, Armstrong DJ, Chan P, Burke FD, Lindau TR. The benefit of radiologically-guided steroid injections for trapeziometacarpal osteoarthritis. Ann R Coll Surg Engl. 2010;92(8):680–4.PubMedCentralCrossRefPubMed
33.
go back to reference Umphrey GL, Brault JS, Hurdle MB, Smith J. Ultrasound-guided intra-articular injection of the trapeziometacarpal joint: description of technique. Arch Phys Med Rehabil. 2008;89:153–6.CrossRefPubMed Umphrey GL, Brault JS, Hurdle MB, Smith J. Ultrasound-guided intra-articular injection of the trapeziometacarpal joint: description of technique. Arch Phys Med Rehabil. 2008;89:153–6.CrossRefPubMed
34.
go back to reference Wajon A, Carr E, Edmunds I, Ada L. Surgery for thumb (trapeziometacarpal joint) osteoarthritis. Cochrane Database Syst Rev. 2009;4:CD004631.PubMed Wajon A, Carr E, Edmunds I, Ada L. Surgery for thumb (trapeziometacarpal joint) osteoarthritis. Cochrane Database Syst Rev. 2009;4:CD004631.PubMed
35.
go back to reference Yao J, Park MJ. Early treatment of degenerative arthritis of the thumb carpometacarpal joint. Hand Clin. 2008;24(3):251–61.CrossRefPubMed Yao J, Park MJ. Early treatment of degenerative arthritis of the thumb carpometacarpal joint. Hand Clin. 2008;24(3):251–61.CrossRefPubMed
Metadata
Title
Intra-articular corticosteroid injections to manage trapeziometacarpal osteoarthritis—a systematic review
Authors
A. Fowler
M. G. Swindells
F. D. Burke
Publication date
01-12-2015
Publisher
Springer US
Published in
HAND / Issue 4/2015
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-015-9778-3

Other articles of this Issue 4/2015

HAND 4/2015 Go to the issue