scholarly journals 1298 Could Antiangiogenic Drugs Be the Solution to Tendon Injury? A Literature Review on The Use of Antiangiogenic Drugs for Tendon Regeneration

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C Kirchhoff
Keyword(s):  
Literature Review ◽  
Intervention Group ◽  
Tendon Healing ◽  
Tendon Injury ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Antiangiogenic Drugs

Abstract Aim Tendinopathy accounts for more than half of reported cases of musculoskeletal injuries worldwide. The subsequent healing process results in a disorganised tendon structure secondary to increased neovascularisation, forming a bulky tendon with overall reduced strength. Current treatment options remain controversial as re-rupture rates following surgical interventions are high. It has been proposed that the use of anti-vascular endothelial growth factors could improve tendon healing. Method This literature review employed a systematic approach. The search strategy incorporated an adjusted PICO format and PRISMA flow diagram. Search findings were critically appraised using the CASP tool checklist. Identified studies investigated the effects of injectable anti-angiogenic drugs following tendon injury. Results Three final studies were identified. Tempfer et al. showed a reduction in cross sectional tendon area in the intervention group (5.6mm² +1.8), comparatively to the control group (9.1mm² +2.0), and increased tensile tendon strength in the intervention group (47.7N+6.41) comparatively to the control group(32.41N+9.23). Dallaudiere (2014) et al. showed a reduced cross-sectional area in the intervention group (0.95mm²+0.01) compared with the control group (0.75mm²+0.01). Dallaudiere (2013) et al. also showed a reduced cross-sectional area in the intervention group (1.10mm²+0.01) compared with the control group (1.11mm²+0.03). Conclusions All studies supported the use of anti-angiogenic drugs to support tendon healing. The use of injectable anti-angiogenic drugs may potentially serve in conjunction with surgical interventions or as an alternative minimally invasive intervention to improve tendon rehabilitation. This review recommends that further randomised control studies could be used to strengthen the current promising evidence base.

EP.FRI.154 Could Antiangiogenic Drugs be the Solution to Tendon Injury? A Literature Review on the use of Antiangiogenic Drugs for Tendon Regeneration

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Chris Kirchhoff
Keyword(s):  
Literature Review ◽  
Surgical Intervention ◽  
Healing Process ◽  
Intervention Group ◽  
Tendon Healing ◽  
Flow Diagram ◽  
Current Evidence ◽  
Control Group ◽  
Cross Sectional ◽  
Antiangiogenic Drugs

Abstract Background Tendinopathy accounts for more than half of reported musculoskeletal injuries worldwide. The subsequent healing process results in a disorganised tendon structure secondary to neovascularisation, forming a bulky tendon with overall reduced strength. Current treatment options remain controversial as re-rupture rates following surgical intervention are high. It has been proposed that the use of anti-vascular endothelial growth factors could improve tendon healing. Methods This literature review employed a systematic approach. The search strategy incorporated an adjusted PICO format and PRISMA flow diagram. Search findings were critically appraised using the CASP tool checklist. Identified studies investigated the effect of injectable anti-angiogenic drugs on tendon healing.  Results Three final studies were identified. Tempfer et al. showed a reduction in cross sectional tendon area in the intervention group (5.6mm²+1.8), comparatively to the control group (9.1mm² +2.0), and increased tendon strength in the intervention group (47.7N+6.41) comparatively to the control group(32.41N+9.23). Dallaudiere (2014) et al. showed reduced cross-sectional area in the intervention group (0.95mm²+0.01) compared with the control group (0.75mm²+0.01). Dallaudiere (2013) et al. also showed reduced cross sectional areas in the intervention group (1.10mm²+0.01) compared with the control group (1.11mm²+0.03).  Conclusion All studies supported the use of anti-angiogenic drugs to support tendon healing. The use of injectable anti-angiogenic drugs may potentially serve in conjunction with surgical intervention or as an alternative minimally invasive intervention to improve tendon rehabilitation. This review recommends that further randomised control studies will be needed to strengthen the current evidence. 

scholarly journals Atrophy patterns in isolated subscapularis lesions

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gernot Seppel ◽  
Andreas Voss ◽  
Daniel J. H. Henderson ◽  
Simone Waldt ◽  
Bernhard Haller ◽  
...  
Keyword(s):  
Muscle Atrophy ◽  
Area Ratio ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
Subscapularis Muscle ◽  
Mri Scans ◽  
The Mean ◽  
The Cross

Abstract Background While supraspinatus atrophy can be described according to the system of Zanetti or Thomazeau there is still a lack of characterization of isolated subscapularis muscle atrophy. The aim of this study was to describe patterns of muscle atrophy following repair of isolated subscapularis (SSC) tendon. Methods Forty-nine control shoulder MRI scans, without rotator cuff pathology, atrophy or fatty infiltration, were prospectively evaluated and subscapularis diameters as well as cross sectional areas (complete and upper half) were assessed in a standardized oblique sagittal plane. Calculation of the ratio between the upper half of the cross sectional area (CSA) and the total CSA was performed. Eleven MRI scans of patients with subscapularis atrophy following isolated subscapularis tendon tears were analysed and cross sectional area ratio (upper half /total) determined. To guarantee reliable measurement of the CSA and its ratio, bony landmarks were also defined. All parameters were statistically compared for inter-rater reliability, reproducibility and capacity to quantify subscapularis atrophy. Results The mean age in the control group was 49.7 years (± 15.0). The mean cross sectional area (CSA) was 2367.0 mm2 (± 741.4) for the complete subscapularis muscle and 1048.2 mm2 (± 313.3) for the upper half, giving a mean ratio of 0.446 (± 0.046). In the subscapularis repair group the mean age was 56.7 years (± 9.3). With a mean cross sectional area of 1554.7 mm2 (± 419.9) for the complete and of 422.9 mm2 (± 173.6) for the upper half of the subscapularis muscle, giving a mean CSA ratio of 0.269 (± 0.065) which was seen to be significantly lower than that of the control group (p < 0.05). Conclusion Analysis of typical atrophy patterns of the subscapularis muscle demonstrates that the CSA ratio represents a reliable and reproducible assessment tool in quantifying subscapularis atrophy. We propose the classification of subscapularis atrophy as Stage I (mild atrophy) in case of reduction of the cross sectional area ratio < 0.4, Stage II (moderate atrophy) in case of < 0.35 and Stage III (severe atrophy) if < 0.3.

scholarly journals Changes in lower extremity blood flow during advancing phases of pregnancy and the effects of special footwear

2017 ◽  
Vol 16 (3) ◽  
pp. 214-219 ◽  
Author(s):  
Marta Gimunová ◽  
Martin Zvonař ◽  
Kateřina Kolářová ◽  
Zdeněk Janík ◽  
Ondřej Mikeska ◽  
...  
Keyword(s):  
Blood Flow ◽  
Venous Blood ◽  
Cross Sectional Area ◽  
Popliteal Vein ◽  
Control Group ◽  
Venous Disease ◽  
Venous Blood Flow ◽  
Sectional Area ◽  
Cross Sectional ◽  
Experimental Group

Abstract Background During pregnancy, a number of changes affecting venous blood flow occur in the circulatory system, such as reduced vein wall tension or increased exposure to collagen fibers. These factors may cause blood stagnation, swelling of the legs, or endothelial damage and consequently lead to development of venous disease. Objectives The aim of this study is to evaluate the effect of special footwear designed to improve blood circulation in the feet on venous blood flow changes observed during advancing phases of pregnancy. Methods Thirty healthy pregnant women participated in this study at 25, 30, and 35 weeks of gestation. Participants were allocated at random to an experimental group (n = 15) which was provided with the special footwear, or a control group (n = 15). At each data collection session, Doppler measurements of peak systolic blood flow velocity and cross-sectional area of the right popliteal vein were performed using a MySonoU6 ultrasound machine with a linear transducer (Samsung Medison). The differences were compared using Cohen’s d test to calculate effect size. Results With advancing phases of pregnancy, peak systolic velocity in the popliteal vein decreased significantly in the control group, whereas it increased significantly in the experimental group. No significant change in cross-sectional area was observed in any of the groups. Conclusions Findings in the experimental group demonstrated that wearing the footwear tested may prevent venous blood velocity from reducing during advanced phases of pregnancy. Nevertheless, there is a need for further investigation of the beneficial effect on venous flow of the footwear tested and its application.

scholarly journals Patients with Achilles Tendon Rupture Have a Degenerated Contralateral Achilles Tendon: An Elastography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Qianru Li ◽  
Qi Zhang ◽  
Yehua Cai ◽  
Yinghui Hua
Keyword(s):  
Achilles Tendon ◽  
Axial Strain ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Computer Assisted ◽  
Study Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean

Purpose. To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods. The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results. The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p<0.001; H20: 0.31±0.10 vs 0.40±0.10, p=0.001; H50: 0.45±0.10 vs 0.53±0.08, p<0.001; Hratio: 1.01±0.25 vs 1.20±0.23, p=0.003). The THK and cross-sectional area of tendons in the study group were larger than those in the control group (p<0.05). Conclusions. As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.

Role of diffusion tensor imaging in the evaluation of ulnar nerve involvement in leprosy

2021 ◽  
pp. 20210290
Author(s):  
Ankita Aggarwal ◽  
Chandan Jyoti Das ◽  
Neena Khanna ◽  
Raju Sharma ◽  
Deep Narayan Srivastava ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Peripheral Neuropathy ◽  
Ulnar Nerve ◽  
Diffusion Tensor ◽  
Cross Sectional Area ◽  
Ulnar Neuropathy ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional

Objective: Early detection of peripheral neuropathy is extremely important as leprosy is one of the treatable causes of peripheral neuropathy. The study was undertaken to assess the role of diffusion tensor imaging (DTI) in ulnar neuropathy in leprosy patients. Methods: This was a case–control study including 38 patients (72 nerves) and 5 controls (10 nerves) done between January 2017 and June 2019. Skin biopsy proven cases of leprosy, having symptoms of ulnar neuropathy (proven on nerve conduction study) were included. MRI was performed on a 3 T MR system. Mean cross-sectional area, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of ulnar nerve at cubital tunnel were calculated. Additional ancillary findings and appearance of base sequences were evaluated. Results: Ulnar nerve showed thickening with altered T2W signal in all the affected nerves, having an average cross-sectional area of 0.26 cm2. Low FA with mean of 0.397 ± 0.19 and high ADC with mean of 1.28 ± 0.427 x 10 −3 mm2/s of ulnar nerve in retrocondylar groove was obtained. In the control group, mean cross-sectional area was 0.71cm2 with mean FA and ADC of 0.53 ± 0.088 and 1.03 ± 0.24 x 10 −3 mm2/s respectively. Statistically no significant difference was seen in diseased and control group. Cut-off to detect neuropathy for FA and ADC is 0.4835 and 1.1020 × 10 −3 mm2/s respectively. Conclusion: DTI though is challenging in peripheral nerves, however, is proving to be a powerful complementary tool for assessment of peripheral neuropathy. Our study validates its utility in infective neuropathies. Advances in knowledge: 1. DTI is a potential complementary tool for detection of peripheral neuropathies and can be incorporated in standard MR neurography protocol. 2. In leprosy-related ulnar neuropathy, altered signal intensity with thickening or abscess of the nerve is appreciated along with locoregional nodes and secondary denervation changes along with reduction of FA and rise in ADC value. 3. Best cut-offs obtained in our study for FA and ADC are 0.4835 and 1.1020 × 10 −3 mm2/s respectively.

scholarly journals Evaluation of Diffusional Characteristics and Microstructure in Unilateral Vocal Fold Paralysis Using Diffusion Tensor Imaging

2019 ◽  
pp. 014556131987472
Author(s):  
Jie Cai ◽  
Logan Klein ◽  
Pinhong Wu ◽  
Azure Wilson ◽  
Xinlin Xu ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Diffusion Tensor ◽  
Vocal Fold Paralysis ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Unilateral Vocal Fold Paralysis ◽  
Cross Sectional ◽  
Injury Group ◽  
The Cross

Objective: To investigate the value of diffusion tensor imaging (DTI) in the evaluation of vocal fold tissue microstructure after recurrent laryngeal nerve (RLN) injury. Methods: Six canines were divided into 2 groups: a unilateral vocal fold paralysis group (n = 4) and a control group (n = 2). The RLN was cut in the unilateral vocal fold paralysis group, and no intervention was applied in the control group. After 4 months, the canines’ larynges were removed and placed in a small animal magnetic resonance imaging (MRI) system (9.4T BioSpec MRI; Bruker, Germany). After scanning, the vocal folds were isolated, sectioned, and stained. The slides were then analyzed for the cross-sectional area and muscle fiber density through feature extraction technology. Pearson correlation analysis was performed on the DTI scan and histological section extraction results. Results: In the vocal fold muscle layer, the fractional anisotropy (FA) of the unilateral RLN injury group was higher than that of the control group, and the Tensor Trace was lower than that of the control group. This difference was statistically significant, P < .05. In the lamina propria, the FA of the unilateral RLN injury group was lower than that of the control group, P > .05, and the Tensor Trace was lower than that of the control group, P < .05. The muscle fiber cross-sectional area of the RLN injury group was significantly smaller than the control group with statistical significance, P < .05, and the density of muscle fibers was lower, P < .05. The correlation coefficient between FA and the cross-sectional area was −0.838, P = .002, and .726; P = .017 between Tensor Trace and the cross-sectional area. Conclusion: Diffusion tensor imaging is an effective method to assess the changes in the microstructure of atrophic vocal fold muscle tissue after RLN injury.

Relationship among running mileage, bone density, and serum testosterone in male runners

1992 ◽  
Vol 73 (3) ◽  
pp. 1165-1170 ◽  
Author(s):  
J. D. MacDougall ◽  
C. E. Webber ◽  
J. Martin ◽  
S. Ormerod ◽  
A. Chesley ◽  
...  
Keyword(s):  
Bone Density ◽  
Bone Mineral ◽  
Cross Sectional Area ◽  
Whole Body ◽  
Control Group ◽  
Dual Photon Absorptiometry ◽  
Sectional Area ◽  
Mineral Density ◽  
Cross Sectional ◽  
Density Measurements

Our purpose was to investigate the relationship between running volume and bone mineral mass in adult male runners. Whole body and regional bone mineral density were determined by dual-photon absorptiometry in 22 sedentary controls and 53 runners who were selected according to their running mileage to fall into a 5- to 10-, 15- to 20-, 25- to 30-, 40- to 55-, or 60- to 75-mile/wk group. All groups were of similar age (20–45 yr) and nutritional status, as determined by 7-day food records. Regional sites for bone density measurements included the trunk, spine, pelvis, thighs, and lower legs. In addition, serum total testosterone was determined in each subject and computed tomography scans were made of the lower legs in 34 subjects to assess bone cross-sectional area. No significant differences were detected for bone density measurements with the exception of the lower legs where it was significantly (P less than 0.05) greater for the 15- to 20-mile/wk group than for the control and 5- to 10-mile/wk groups. With mileage greater than 20 miles/wk, bone density of the lower legs showed no further increase and, in fact, tended to decrease, so that for the 60- to 75-mile/wk group it was similar to that of the controls. Cross-sectional area of the tibia and fibula when normalized to body weight tended to be greater as weekly mileage increased and was significantly greater in the 40- to 55-mile/wk runners than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

The Role of the Paratenon in Achilles Tendon Healing: A Study in Rats

2018 ◽  
Vol 46 (5) ◽  
pp. 1214-1219 ◽  
Author(s):  
Sebastian A. Müller ◽  
Christopher H. Evans ◽  
Patricia E. Heisterbach ◽  
Martin Majewski
Keyword(s):  
Achilles Tendon ◽  
Tendon Healing ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Sprague Dawley ◽  
Cross Sectional ◽  
Collagen Formation ◽  
Tendon Defect ◽  
Tear Resistance

Background: The role of the paratenon in tendon healing is unknown. The present study compares healing in the presence or absence of the paratenon in an Achilles tendon defect model in rats. Hypothesis: Resection of the paratenon impairs tendon healing. Study Design: Controlled laboratory study. Methods: Sixty skeletally mature Sprague Dawley rats were randomly assigned to either a resected paratenon (RP) group or an intact paratenon (IP) group. In all animals, a 4-mm portion of the Achilles tendon was resected in the midsubstance. In the RP group, the paratenon was resected completely. In the IP group, the paratenon was opened longitudinally and closed again after the tendon defect had been created. One, 2, and 4 weeks after surgery, 7 animals per group were tested biomechanically and 3 animals per group examined histologically. Results: The recovery of mechanical strength was much more rapid in IP tendons. Tear resistance was significantly increased for IP tendons (41.3 ± 8.8 N and 47.3 ± 14.1 N, respectively) compared with RP tendons (19.3 ± 9.1 N and 33.2 ± 6.4 N, respectively) after 1 and 2 weeks. The cross-sectional area was larger in the IP group after 1 and 2 weeks (8.2 ± 2.3 mm2 and 11.3 ± 3.1 mm2 vs 5.0 ± 2.4 mm2 and 5.9 ± 2.0 mm2, respectively) compared with the RP group. Tendon stiffness was greater in the IP group after 1 week (10.4 ± 1.9 N/mm vs 4.5 ± 1.6 N/mm, respectively) compared with the RP group. In comparison, normal contralateral tendons had a maximal tear resistance of 56.6 ± 7.2 N, a cross-sectional area of 3.6 ± 0.7 mm2, and stiffness of 17.3 ± 3.8 N/mm. Hematoxylin and eosin staining revealed slightly delayed healing of RP tendons. Early collagen formation was seen in the IP group already after 1 week, whereas in the RP group, this only occurred after 2 weeks. After 4 weeks, the IP tendons showed more collagen crimp formation than the RP tendons. Conclusion: An intact paratenon promotes healing of the Achilles tendon. Clinical Relevance: Although incision or resection of the paratenon has been advocated when repairing injured or degenerative tendons, our data suggest that the integrity of the paratenon should be preserved.

Effects of weight loss in ewes in early pregnancy on muscles and meat quality of lambs

1999 ◽  
Vol 132 (1) ◽  
pp. 103-116 ◽  
Author(s):  
D. I. KRAUSGRILL ◽  
N. M. TULLOH ◽  
W. R. SHORTHOSE ◽  
K. SHARPE
Keyword(s):  
Body Weight ◽  
Meat Quality ◽  
Early Pregnancy ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Muscle Weight ◽  
Cross Sectional ◽  
Crown Rump Length ◽  
The Cross

Three successive experiments, of similar design, were carried out during 1986–88 at Mount Derrimut, Australia. Mature Merino ewes were mated to Poll Dorset rams and then allocated to either a control group (C) or a treatment group (R). Ewes from each treatment were slaughtered 60, 70, 100 or 140 days post-conception and the development of their foetuses was compared in terms of body size and muscle characteristics. In Expts 1 and 2, some ewes were allowed to lamb and the progeny in each group were slaughtered after reaching a body weight of 35 kg, for comparison of growth rates, muscle characteristics and meat quality.In each experiment, treatment extended from mating to day 70 of pregnancy and, during this period, both groups were housed. Ewes in group C were kept as one group and fed ad libitum and ewes in group R were individually penned and fed a restricted ration of the same diet as that given to group C in order to achieve a steady loss of body weight. In Expt 1, this loss was 8 kg but, in Expts 2 and 3, feed intake was controlled according to condition score and, during this period, group R ewes lost 25–35% of their body weight at mating. After day 70, all ewes were kept grazing and were offered supplementary feed at rates sufficient for a steady increase in ewe body weights.Foetuses in group R were lower in body weight (P<0·05), crown-rump length (P<0·05) and girth (P<0·01). However, birth weights and mean ages of the 35 kg lambs at slaughter did not differ significantly between treatments.There were no significant differences between treatments for the semitendinosus (ST) and semimembranosus (SM) muscles in total muscle weight, DNA content, protein content, nor in the ratios of muscle weight[ratio ]DNA and protein[ratio ]DNA. However, there were significant differences between experiments, which indicated that cell size in the ST and SM muscles was lower in Expt 2 than in Expt 1.In day 70 foetuses, the cross-sectional area of α fibres was greater (P<0·05) in group R than in group C but by day 140 the difference was no longer significant. At day 70, there was also a positive correlation (r=0·65, P<0·01) between the cross-sectional area of β fibres and the number of α fibres surrounding each of them. There were no significant differences between treatments at any age in the percentages of βR, αR and αW fibres.Meat from group R lambs was more tender than that from group C lambs as indicated by significantly lower means in the SM muscle for adhesion (P<0·01) and Warner–Bratzler Peak Force (WB PF) measurements (P<0·05).Although some effects of nutritional restriction were found, severe feed shortage in early pregnancy in sheep is unlikely to have significant effects on the production of prime lamb meat provided that adequate nutrition is available during late pregnancy and post-natal growth.

The effect of thumb splinting on thenar muscles atrophy, pain, and function in subjects with thumb carpometacarpal joint osteoarthritis

2016 ◽  
Vol 41 (4) ◽  
pp. 379-386 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Mohaddeseh Soflaei ◽  
Monireh Ahmadi Bani ◽  
Seyed Pezhman Madani ◽  
Mahsa Sattari ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Treatment Effects ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Carpometacarpal Joint ◽  
Analog Scale ◽  
Cross Sectional ◽  
Custom Made ◽  
First Carpometacarpal Joint

Background: When the first carpometacarpal joint of the wrist is immobilized using an orthosis to combat the effects of osteoarthritis, atrophy of the thenar muscles may occur. Objectives: The aim of this study was to evaluate the thenar muscle diameter and cross-sectional area, joint function, and pain, before and after being supplied with an orthosis in patients with grades 1 and 2 carpometacarpal osteoarthritis compared to a control group. Study design: Randomized clinical trial. Methods: A total of 25 volunteer patients were randomized into two groups (an orthosis group and a control group) using a randomization table. A visual analog scale, the Michigan Hand Questionnaire, and ultrasound were used to measure pain, function, and specific muscle cross-sectional areas at baseline and after 4 weeks in both groups. Results: Mean visual analog scale pain scores decreased by 20% after 4 weeks of splinting, while those in the control group decreased by 3%. Changes in scores were significantly different between both groups ( p = 0.001). There was no significant difference between the groups in either the Michigan Hand Questionnaire score or the muscle cross-sectional area. Conclusion: A large and significant effect on perceived pain in patients with first carpometacarpal joint osteoarthritis was observed after 4 weeks of splint use. Differences in treatment effects were found with regard to muscle cross-sectional areas, but these were not significant. Clinical relevance Custom-made splints may be recommended for the treatment of first carpometacarpal joint osteoarthritis. Moderate to large but non-significant treatment effects were found with regard to muscle cross-sectional areas.

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