***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aims of this r and omized controlled trial were to evaluate the efficacy of intra-articular Hylan G-F 20 on the pain , pinch strength , and functional status in patients with thumb base osteoarthritis ( OA ) . Sixty-six h and s of 33 female patients ( mean age , 62.6 ± 6.4 years ) with bilateral clinical and radiological thumb base OA were included into this study . H and s of the same patient were divided to Hylan G-F 20 and saline-injection groups . VAS pain 100 mm , pinch strength ( key , tripod and pulp to pulp pinch ) and functionality ( Dreiser functional index ) were assessed at baseline , at sixth and 24th weeks . Statistically significant improvements were detected in function ( p = 0.001 ) , VAS pain ( p = 0.002 ) , and pinch strength ( p = 0.004 ) at the 24th week in the Hylan G-F 20 group . However , only VAS pain scores decreased temporarily in control h and s at the 6th week ( p = 0.02 ) . Although short-term placebo analgesic effect could not be ignored , intra-articular hylan was effective on pain , pinch strength , and function at the 24th week Objective : To determine the difference in the usability of three types of thenar eminence ( TE ) orthoses . Design : Prospect i ve comparative pre-experimental study with r and omized cross-over design . Setting : Rehabilitation centre . Subjects : Ten patients with osteoarthritis of the carpometacarpal I joint confirmed by X-ray . Intervention : Three types of TE orthoses , made of either supple elastic material , elastic material with a semi-rigid thumb busk or a semi-rigid ( polyethylene ) material . Main outcome measurements : Pain at the thenar eminence , pinch force , h and function , cosmesis , comfort and function of the TE orthosis . Results : The supple elastic TE orthosis scores significantly better than the more rigid types on the subjects ‘ comfort ’ , ‘ function ’ and the Green Test , while the semi-rigid orthosis scores best on ‘ cosmesis ’ . The score on the subject ‘ pain reduction ’ shows no significant difference between the three types of TE orthoses . The scores obtained correspond with the outcome of structured interviews about the usability of the TE orthoses . Conclusion : Eight out of 10 patients prefer the permanent use of a TE orthosis . Six patients chose the supple elastic orthosis and two chose the semi-rigid orthosis The purpose of this study was to compare the effects of two 6-week splint and exercise regimens for patients with trapeziometacarpal osteoarthritis . Forty participants were enrolled in a r and omised , controlled clinical trial . The experimental group received a newly design ed thumb strap splint and an abduction exercise regimen , whereas the control group received current clinical practice consisting of a short opponens splint and a pinch exercise regimen . Outcome measures included pain ( VAS at rest in cm ) , strength ( tip pinch in kg ) , and h and function ( Sollerman Test of H and Function scored out of 80 ) , measured by a blinded assessor at Weeks 0 , 2 , and 6 . By Week 6 there was no significant difference in the extent of mean improvement between the groups in : pain , 0.5 cm ( 95 % CI -1.1 to 2.1 ) ; strength , 0.1 kg ( 95 % CI -0.8 to 0.9 ) ; or h and function , 0.7 points ( 95 % CI -3.6 to 5.0 ) . While both groups improved , neither regimen is superior to the other in patients with trapeziometacarpal osteoarthritis OBJECTIVE Prospect i ve assessment of the efficacy and tolerability of intra-articular sodium hyaluronate ( SH ; Ostenil mini ) and triamcinolone acetonide ( TA ; Volon A10 ) for treatment of osteoarthritis ( OA ) of the carpometacarpal ( CMC ) joint of the thumb in a 26-week , controlled , r and omized , on an intention to treat , masked-observer study . METHODS Patients were treated with three intra-articular injections of either SH ( n = 28 ) or TA ( n = 28 ) . Primary assessment s were pain according to a 100 mm visual analogue scale and extensive clinical and functional parameters such as swelling , grip power and range of motion . The population was analysed using one- and two-sided Mann-Whitney ( MW ) estimators . RESULTS Maximum pain relief occurred at 2 - 3 weeks for TA and at week 26 for SH after the first intra-articular injection . At weeks 2 - 3 TA was significantly better than SH ( MW : 0.3319 and 0.3063 ; P = 0.9827 and 0.9929 ) . At week 26 a slight superiority of SH could be observed ( MW : 0.53 ; P = 0.3624 ) and non-inferiority could be proven . After 26 weeks lateral pinch power was significantly better in the SH-group ( MW : 0.6331 ; P = 0.0226 ) . In all , 88.0 % of patients treated with SH and 79.1 % of the TA-group described pain improvement after 26 weeks . Both agents were well tolerated . No adverse events with causal connection to the investigational products occurred . CONCLUSION A single course of three SH injections is effective in relieving pain and improving joint function in patients with OA of the CMC joint of the thumb . Although in comparison with triamcinolone its effects are achieved more slowly , the results indicate a superior long-lasting effect of hyaluronan at 6 months after end of treatment period PURPOSE Conservative , nonsurgical therapies for basal joint osteoarthritis , such as thumb spica splinting and intra-articular corticosteroid injections , remain the mainstays for symptomatic treatment . This study compares intra-articular hylan , corticosteroid , and placebo injections with regard to pain relief , strength , symptom improvement , and metrics of manual function in a r and omized , controlled , double-blinded study . METHODS Sixty patients with basal joint arthritis were r and omized to receive 2 intra-articular hylan injections 1 week apart , 1 placebo injection followed by 1 corticosteroid injection 1 week later , or 2 placebo injections 1 week apart . Patients were evaluated at 2 , 4 , 12 , and 26 weeks and assessed with Visual Analog Scale pain scores , strength measures , difference scores , Disabilities of the Arm , Shoulder , and H and ( DASH ) scores , and range of motion measurements . RESULTS All groups reported pain relief at 2 weeks . The steroid and placebo groups had significantly less pain at week 4 compared with baseline , but this effect disappeared by week 12 . Only hylan injections continued to provide pain relief at 12 and 26 weeks compared with baseline . There were no significant differences in pain between groups at any time . At 12 and 26 weeks , the hylan group had improved grip strength compared with baseline , whereas the steroid and placebo groups were weaker . At 4 weeks , the steroid group reported in the difference score a greater improvement in symptoms ( 68 % ) compared with the hylan ( 44 % ) and placebo ( 50 % ) groups . Whereas at 26 weeks the hylan group reported the largest improvement in symptoms ( 68 % ) , this was not statistically different from the placebo ( 47 % ) and steroid ( 58 % ) groups . There were no significant differences in Disabilities of the Arm , Shoulder , and H and scores or range of motion among the groups . There were no complications from any injection . CONCLUSIONS There were no statistically significant differences among hylan , steroid , and placebo injections for most of the outcome measures at any of the follow-up time points . However , based on the durable relief of pain , improved grip strength , and the long-term improvement in symptoms compared with preinjection values , hylan injections should be considered in the management of basal joint arthritis of the thumb . TYPE OF STUDY /LEVEL OF EVIDENCE Therapeutic The purpose of this study was to compare the objective , subjective , and radiographic responses of patients with carpometacarpal joint osteoarthritis ( CMCJ-OA ) wearing a prefabricated neoprene splint ( PFN ) , which crosses the CMCJ and metacarpophalangeal joint , with those of patients wearing a custom-made thermoplastic short opponens splint ( CMT )  , which crosses only the CMCJ . Patients ( N = 25 ) with first CMCJ stage I and II osteoarthritis were assigned r and omly to wear either the PFN splint or the CMT splint for one week . After one week , the subjects rated their function in the splint and their satisfaction and pain levels on visual analogue scales . Pinch measurements were performed and x-rays were taken to assess carpometacarpal subluxation . The second splint was then applied for one week and all measures were repeated . The subjects rated the  PFN splint  significantly higher , and most reported that they would choose the PFN splint over the CMT splint for daily and long-term use . Both pain and function were improved with splinting , but the effect was amplified with the PFN splint compared with the CMT splint . Both splints reduced subluxation at the first carpometacarpal joint , but the  CMT effect was greater . This study further supports current evidence that subjects with stage I and II first CMCJ-OA will have pain relief with thumb splinting . In addition , the PFN splint will provide greater relief when compared with the CMT splint . Furthermore , this study reveals that patients prefer the PFN splint to the CMT splint 
    Output:
    
Systematic evaluation demonstrated the following : ( 1 ) H and therapy can possibly reduce pain .
2 ) Although both steroid and hyaluronate intra-articular injections can provide pain relief , most authors conclude that injection of hyaluronate is more effective .
3 ) The use of orthoses reduces pain without effect on function , strength , or dexterity .
6 ) There are no high-level evidence studies specifically evaluating the effect of analgesics and patient education in joint protection in patients with thumb base OA .
Available evidence suggests only some effect of orthoses and intra-articular hyaluronate or steroid injections