Autologous Fat Grafting for Trapeziometacarpal Joint Osteoarthritis: A Systematic Review of Effectiveness and Outcomes

Background: Carpometacarpal-1 joint osteoarthritis (CMC-1 OA) is a common degenerative hand condition that significantly impairs hand function and quality of life, with autologous fat grafting (AFG) emerging as a promising treatment option. This study aims to conduct a systematic review of the outcomes of the use of AFG for CMC-1 OA. Methods: A comprehensive literature search was conducted across various databases. Ten relevant studies were identified, analysed and assessed for risk of bias (ROB) using the Cochrane Systematic Review RCT ROB assessment tool, Evidence Project ROB tool and the Joanna Briggs Institute Critical Appraisal Checklist. Results: The review included one RCT, two prospective comparative studies, four prospective non-comparator studies and three case series. Post-AFG, pain decreased by an average of 4.5 points on the visual analogue scale. Patient-reported outcomes improved by 60% in Arm, Shoulder and Hand Disability scores. Pinch grip and grip strength results varied, with only two studies showing significant improvements. Patient satisfaction was high: 83% would recommend the treatment, and 73% would undergo it again. Surgical revision rates fluctuated, peaking at 38.7% over 5 years. Conclusions: AFG shows promise as a lasting treatment for CMC-1 OA, providing significant pain relief and improved hand function. However, more studies on objective outcomes are necessary to establish its efficacy. Level of Evidence: Level III (Therapeutic)