Table 1.
Summary of selected studies.
Author | Country | Inclusion | Exclusion | Intervention | Regime and dose | Comparator | Regime and dose | Comparator 2 | Regime and dose | Injection technique |
---|---|---|---|---|---|---|---|---|---|---|
Bahadir 2009 | Turkey | Grade 2 or 3 Eaton & Littler | Inflammatory arthritis, trauma, carpal tunnel, previous injection | Triamcinolone acetonide | One injection of 20 mg/0.5 mL of triamcinolone acetatonide the start of the trial | Hyaluronic acid | Weekly injections of 5mg/0.5 mL of sodium hyaluronate for 3 weeks | n/a | n/a | Needle inserted just proximal to the radial base of the first metacarpal bone, volar to the extensor pollicis brevis tendon. Hand supine |
Figen Ayhan and Ustün 2009 | Turkey | Bilateral symptoms with failed prior treatment, VAS >40/100, radiographic evidence of grade 1–4 Eaton & Littler | Previous injection, trauma, inflammatory arthritis, joint infection | Hyaluronic acid | One injection of 1 mL of Hylan G-F20 at the beginning of the study | Saline | One injection of 1 mL saline at the beginning of the study | n/a | n/a | Needle inserted in the dorsal aspect of the radial side of the 1st carpometacarpal joint by holding the thumb in slight flexion. Hand prone |
Heyworth 2008 | USA | Symptomatic osteoarthritis | Multiple previous injections, pregnancy, previous surgery, trauma to joint, inflammatory arthritis | Betamethasone acetate | Two injections, first saline 1 mL at baseline followed by 1 mL sodium betamethasone a week later | Hyaluronic acid | Two 8 mg injections of hylan G-F 20, first at baseline and second a week later | Saline | Two injections of 1 mL saline, first at baseline and second a week later | nm |
Malahias 2021 | Greece | Clinical and radiographic evidence of TBOA, grades 1 to 3 Eaton & Littler | Systemic rheumatic disease, self-reported comorbid hand conditions, history of gout or pseudogout, bleeding predisposition, previous surgery to the affected thumb, previous injection, grade 4 Eaton & Littler | Methylprednisolone succinate | Two injections of 125mg/2 mL methylprednisolone sodium succinate 15 days apart | Platelet rich plasma | Two injections of platelet rich plasma injections 15 days apart. Platelet rich plasma mannually prepared | n/a | n/a | Ultrasound guided injection using free hand one man's technique |
Monfort 2015 | Spain | Symptoms lasting >90 days requiring analgesic relief, at least grade 1 Kellgren-Lawrence | Pregnancy, severe renal/liver disease, injection within last 3 months, previous thumb surgery, previous physical therapy | Betamethasone acetate | Once weekly injections of 0.5 mL betamethasone disodium phosphate 1.5 mg and betamethasone acetate 1.5 mg for 3 weeks | Hyaluronic acid | Once weekly injections of 0.5 mL of hyaluronic acid 5 mg/mL 500–1000 kDa for 3 weeks | n/a | n/a | Ultrasound guided injection inserted lateral to the abductor pollicis longus tendon using free hand one man's technique. Hand semi-prone |
Sabah 2020 | Egypt | Failed conservative treatment of at least 4 weeks | TBOA with failed conservative treatment of at least 4 weeks | Betamethasone acetate | One injection of 1 mL betamethasone acetate the start of the trial | Hyaluronic acid | One injection of containing 730,000 Da of hyaluronic acid at the start of the trial | Platelet Rich Plasma | One injection of 20 mL of platelet rich plasma at the start of trial. Platelet rich plasma produced by commercial kit | Needle inserted just proximal to the radial base of the first metacarpal bone, volar to the extensor pollicis brevis tendon. Hand supine |
Stahl 2005 | Israel | Symptomatic CMCJ OA grade 2 Eaton Littler classification | nm | Methylprednisolone acetate | One injection of 40 mg methylprednisolone acetate at beginning of study | Hyaluronic acid | One injection of 15 mg of hyaluronic acid at beginning of study | n/a | n/a | Needle inserted in the dorsal aspect of the radial side of the 1st carpometacarpal joint by holding the thumb in slight flexion. Hand prone |
Comparative Case Series | ||||||||||
Tenti 2017 | Italy | Age 45–75, symptoms >3 months, VAS >30/100, grade 2 or 3 Kellgren-Lawrence | Inflammatory joint disease, septic arthritis, major trauma, prior surgery of upper limb, coagulation disorders, severe comorbidity, therapy with chondroitin sulfate, glucosamine, diacerein and steroids | Triamcinolone acetonide | Two injections of 0.5 mL of triamcinolone acetonide 20 mg/mL at baseline and at 15 days | Hyaluronic acid | Two injections of 1 mL of Sinovial H-L 3.2 % 16 mg + 16 mg/mL baseline and 15 days | n/a | n/a | Needle inserted lateral to the abductor pollicis longus tendon using free hand one man's technique. Hand semi-prone |
n/a – not applicable.
nm – not mentioned.