***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: PURPOSE To report results on 144 cases following arthroscopic resection arthroplasty ( ARA )  with or without interposition for basal joint arthritis . METHODS Cases undergoing ARA for thumb carpometacarpal osteoarthritis between 2004 and 2011 were prospect ively enrolled ( n = 178 ) . Data were collected before surgery and after surgery at 1 , 3 , 6 , and 12 months and annually thereafter . Patients were excluded for less than 1-year follow-up or concomitant procedures that interfered with evaluation of the variable of interest ( interposition ) . Human acellular dermal matrix ( GRAFTJACKET ) was the most commonly used interposition . Outcomes on 19 cases of interposition using collagen bioimplant ( OrthADAPT ) and porous polyurethaneurea ( Artelon ) scaffolds were also reported . Comparative analyses were performed on 52 patients with GRAFTJACKET interposition and on 73 without . Mean follow-up was 7.4 and 5.6 years with and without interposition , respectively . Descriptive statistics were evaluated on all baseline variables . Raw change scores of grip , pinch , and pain outcomes were evaluated . Confounding variables at a significance level of P less than .05 were adjusted for in linear mixed models , and an analysis of covariance was employed through an unstructured type of variance-covariance matrix . RESULTS Change scores from baseline to 1 year for the interposition group for pain ( numerical rating scale , 0 - 10 ) , pinch , and grip was -5.8 , 3.3 , and 7 , respectively , and -5.1 , 2.1 , and 9 for the noninterposition group . Postoperative mean satisfaction was 4.7 and 4.4 for the with- and without-interposition groups , respectively . There were 4 failures with and 2 without interposition . Artelon and OrthADAPT did poorly with unacceptably high failure rates . CONCLUSIONS This study suggested that interposition is not necessary following ARA for thumb basal joint arthritis . Because arthroscopic interposition of material contributes to health care costs in terms of patient and facility costs without clear benefit to the patient , routine use of expensive interposition products should be ab and oned or carefully evaluated with a prospect i ve r and omized controlled trial . TYPE OF STUDY /LEVEL OF EVIDENCE Therapeutic IV OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity PURPOSE To determine whether arthroscopic debridement and synovectomy of the thumb carpometacarpal joint improves subjective and objective outcomes in patients with stage I and stage II basal joint arthritis . METHODS Twenty-three patients with stage I or stage II basal joint arthritis were treated with arthroscopic synovectomy and joint debridement .  Twenty-one age- and gender-matched patients were treated with additional forms of nonoperative therapy ( control group ) . Change in visual analog scale ( VAS ) , Disabilities of the Arm , Shoulder and H and ( DASH ) , and subjective scores and change in pinch strength were evaluated 12 months after treatment . RESULTS The pretreatment mean VAS , DASH , and subjective scores for the surgical and control groups were 7.7 and 7.5 , respectively ( P = .3 ) ; 55.6 and 54.4 , respectively ( P = .3 ) ; and 4 and 4 , respectively ( P = .9 ) . At follow-up , the mean VAS , DASH , and subjective scores for the surgical and control groups were 2.7 and 7.3 , respectively ( P < .001 ) ; 26 and 53.1 , respectively ( P < .001 ) ; and 1.8 and 3.8 , respectively ( P < .001 ) . At follow-up , mean pinch strength for the surgical and control groups was 6.2 + /- 1.3 kg and 4.9 + /- 1.1 kg , respectively ( P < .001 ) . Eighty-three percent of the surgical patients reported their result as either good or excellent . There were no significant complications . CONCLUSIONS This study shows that arthroscopic debridement and synovectomy improve pain scores , functional scores , subjective outcome , and pinch strength more so than traditional nonoperative therapy 
    Output:
    
The use of arthroscopic-assisted techniques for thumb CMC OA is still limited ; however , it may be a reasonable option for patients with thumb CMC OA who do not respond to non-operative treatment