Conservative treatments for De Quervain's tenosynovitis: A systematic review and network meta-analysis
Abstract
Background: De Quervain's tenosynovitis (DQT) is a common tendinopathy of the first dorsal compartment, managed conservatively or surgically. Among conservative options, the comparative effectiveness remains unclear.
Purpose: To evaluate the effectiveness of conservative treatments for DQT.
Study design: Systematic review and network meta-analysis (NMA).
Methods: Following PRISMA and a PROSPERO registration (CRD42023494486), seven databases were searched for randomized controlled trials (RCTs) and non-RCTs. Twenty-one studies (1,178 adults) were included in the qualitative synthesis; 12 entered the NMA. Pain was measured with the visual analog scale or Numerical Pain Rating Scale; function with the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, or the Duruöz Hand Index. Data were analyzed with frequentist multivariate and univariate NMAs. Interventions were ranked using p scores and the Surface Under the Cumulative Ranking curve. Risk of bias and certainty of evidence were assessed with the Cochrane Risk of Bias 2.0 tool, Risk of Bias in Non-randomized Studies of Interventions, and Grading of Recommendations Assessment, Development, and Evaluation criteria.
Results: Full-time orthosis use plus corticosteroid injection ranked highest for pain and functional improvement, followed by corticosteroid injection alone and acupuncture. All active treatments outperformed waitlist controls. Pain outcomes…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,178 participants or records.
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