Abstract：
Background: Arthroscopic debridement is increasingly being utilised in patients with early-stage first carpometacarpal joint (FCMCJ) arthritis but has limited supportive evidence. This systematic review evaluates the literature, and reports on outcomes and adverse events following this procedure. Methods: An electronic literature search of PubMed, Embase, Medline and Cochrane Central, looking for studies describing outcomes following arthroscopic debridement in FCMCJ arthritis, was performed in November 2022. Studies where bony resection or interposition was performed as adjuncts were excluded. Reported outcomes included visual analogue scores (VAS) for pain; Disabilities of Arm, Shoulder and Hand (DASH) scores; pinch and grip strength; complications and re-operations. Results: Out of a total of 90 studies revealed from the search, only two studies were eligible for inclusion, with a cohort of 34 patients. Following arthroscopic debridement for FCMCJ osteoarthritis, the mean VAS improved by four units, mean DASH by 22 points, grip strength by 4.5 kg and pinch strength by 2 kg at mean follow-up of 18 months. The pooled complication and re-operation rates were 8.8% and 23.5%, respectively. Conclusions: There is a lack of evidence supporting the utility of FCMCJ arthroscopy and debridement in the management of patients with early arthritis. Although the limited evidence suggests that there may be some therapeutic benefit, further large-scale prospective studies need to be performed before making conclusive recommendations. Level of Evidence: Level III (Therapeutic).
摘要：
背景：关节镜清创术越来越多地用于早期第一腕掌关节（FCMCJ）关节炎患者，但支持性证据有限。这篇系统的综述对文献进行了评估，并报告此程序后的结果和不良事件。方法:PubMed电子文献检索,Embase,Medline和CochraneCentral,寻找描述FCMCJ关节炎关节镜清理后结果的研究，于2022年11月进行。排除进行骨切除或间置术作为辅助手段的研究。报告的结果包括疼痛的视觉模拟评分(VAS)；手臂残疾，肩和手（DASH）评分；捏和握力；并发症和再次手术。结果：在搜索显示的90项研究中，只有两项研究有资格纳入，与34名患者的队列。FCMCJ骨关节炎的关节镜清理术后，平均VAS提高了四个单位，平均DASH22分，平均随访18个月，握力4.5kg，捏力2kg。合并并发症和再次手术率分别为8.8%和23.5%，分别。结论：缺乏证据支持FCMCJ关节镜和清创术在治疗早期关节炎患者中的实用性。尽管有限的证据表明可能有一些治疗益处，在提出结论性建议之前,还需要进行进一步的大规模前瞻性研究.证据级别：III级（治疗）。
