Background: 1st carpometacarpal (CMC) (base of thumb) arthritis is a prevalent condition, often leading to surgical intervention, such as trapeziectomy or joint replacement. Rehabilitation following thumb base replacement surgery is key to functional recovery, reducing pain, and improving the quality of life for patients. However, there is a lack of consensus regarding the most effective rehabilitation protocols, and existing guidelines vary significantly. Wouters et al (2018) reported the results of a review of post-operative rehab in this population however they noted a lack of comparative studies at that time. This systematic review aims to evaluate and synthesize the available evidence on rehabilitation interventions post-base of thumb replacement surgery.
Objectives: The primary objective of this review is to synthesise and assess the effectiveness of various rehabilitation strategies following 1st CMC replacement surgery. Secondary objectives include identifying optimal timing, intensity, and modalities for rehabilitation, as well as examining the impact of rehabilitation on postoperative outcomes such as range of motion, pain, grip strength, functional recovery, and patient-reported outcomes.
Methods: A systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We will search electronic databases including PubMed, Cochrane Library, and CINAHL for randomized controlled trials, cohort studies, and case-control studies published from inception to the present. Eligible studies must focus on rehabilitation protocols following 1st CMC replacement surgery and report relevant outcomes. Data will be extracted and analyzed in terms of rehabilitation interventions, outcomes, and methodological quality. The Consensus on Exercise Reporting Template (CERT) will be used to evaluate the completeness of exercise reporting. Meta-analysis will be performed if data is suitable.
Conclusion: This review will contribute valuable evidence to guide clinicians in optimizing rehabilitation for patients undergoing base of thumb replacement surgery, ultimately aiming to improve recovery outcomes and enhance patient well-being.