LAUSR

BACKGROUND For the treatment of CMC arthritis of the thumb various therapies are used. Infiltration therapy with autologous substances such as platelet-rich plasma and autologous fat have recently gained increasing attention due to beneficial pain-reducing effects in arthritis and the associated regenerative potential.The extent of clinical evidence in this area, however, and how well autologous substances work in terms of pain reduction and improvements in hand function remains unclear. METHODS A systematic review and meta-analysis were conducted to evaluate the current evidence and to provide more insight into pain reduction and improvement in hand function after infiltration of autologous substances. We identified 11 clinical trials of which we included 8 in the meta-analysis. RESULTS Autologous substances achieved a good and long-lasting pain reduction, which may also be accompanied by corresponding improvement in hand function. Autologous substances appear to be more effective than corticoid infiltrations. The infiltration of autologous fat seems to be particularly promising in more advanced stages of CMC arthritis of the thumb also.Our meta-analysis showed a mean pain reduction of 2.4-3 in VAS score and a reduction of 18-19 points in the DASH questionnaire after infiltration with autologous substances. CONCLUSIONS In conclusion, both PRP and autologous fat infiltration offer an efficient and long lasting minimally invasive therapy option in the treatment of CMC arthritis of the thumb.