Immobilization, rehabilitation and complications classification after thumb trapeziometacarpal total joint arthroplasty: A scoping review

Optimal immobilization and rehabilitation after trapeziometacarpal total joint arthroplasty are unclear. We aimed to identify and describe the available evidence, practices and knowledge gaps. The literature was searched without restrictions. 123 studies were included, reporting 21 types of prosthesis. Types of immobilization comprised cast (23%), splint (18%), compression bandage (10%), or combinations (26%). In 19% of the articles, immobilization time and type were not reported. Types of rehabilitation comprised supervised rehabilitation (22%), self-rehabilitation (11%), functional use (11%), and customized rehabilitation (16%). In 28% of the articles, type of rehabilitation was not reported. Two studies (2%) used complications classifications. Time to complications was not reported in 53 articles (43%). Multiple gaps in the evidence exist, with a lack of studies comparing types of immobilization as and rehabilitation. Currently there is no scientific evidence for the superiority of any particular postoperative regime, and decision-making is based on clinical experience rather than evidence, explaining the wide variations in practices.