Comparison of efficiency between platelet rich plasma and corticosteroid injection therapies in patients with Carpal tunnel syndrome: a prospective randomized controlled study

Abstract

Background: Carpal tunnel syndrome (CTS) is the most common upper limb entrapment neuropathy caused by compression of the median nerve as it traverses the wrist at the carpal tunnel. Objectives: To compare the effect of single dose of platelet-rich plasma (PRP) injected locally with that of corticosteroid in patients with CTS. Subjects and methods: A total of 60 patients with very mild to moderate unilateral CTS were recruited to the study. PRP was prepared via two centrifugation procedures. The patients were randomly divided into three groups PRP [i] group, PRP [ii] group, and a third group that received local corticosteroid injection (CS). The patients were followed up at 1.5 and 3 months by visual analog scale (VAS) for pain assessment. The severity and functional outcomes were evaluated through Boston CTS, and neurophysiological analyses were carried out. Results: On comparing the PRP [i], PRP [ii], and CS groups, a statistically significant enhancement of all outcome variables was observed in both PRP groups at follow-up except VAS at 3 and 6 months (P = 0.073 and P = 0.068, respectively) in PRP [ii] group. Conclusion: In CTS, PRP was a better treatment alternative with respect to pain and functional outcome. In addition, it was associated well with improved neurophysiological values than those observed after corticosteroid injection.

Effect of Platelet-Rich Plasma Injection on Mild or Moderate Carpal Tunnel Syndrome: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…When Uzun et al's study [ 13 ] was removed, BCTQs at 3rd-month follow-up was P < 0.00001, I 2 = 1% without additional heterogeneity. Similarly, there was no heterogeneity in DML after removing Hashim et al's study [ 30 ] ( P = 0.91, I 2 = 0%). Besides, the results did not show substantive difference compared to the original analysis in remaining indicators.…”

“…All studies compared clinical outcomes of PRP injection versus other conservative treatments for management of mild to moderate CTS. Besides, control groups comprised corticosteroid injection in 5 trials [ 13 , 27 – 30 ], saline injection in 1 trial [ 31 ], and a splint in 3 trials [ 32 – 34 ]. Of the 9 included studies, 7 studies were considered to have a low risk of bias, while the 2 remaining studies were found to have a high risk of bias.…”

“…Among the included studies, different concentration processes were used resulting in variable concentrations of platelets and other elements. Unfortunately, the enrichment percentages were not reported except for one study by Hashim et al [ 30 ]; however, no significant results were observed between two PRP groups. Hence, further studies are necessary to address this issue.…”

Effectiveness of Platelet-Rich Plasma for Patients With Carpal Tunnel Syndrome: A Systematic Review and meta-Analysis of Current Evidence in Randomized Controlled Trials

“…Through reading the full text, fifteen records were excluded because of irrelevant to our topics, no relevant data and ongoing clinical research that has not yet been published. Finally, eight RCTs ( Wu et al, 2017 ; Malahias et al, 2018 ; Raeissadat et al, 2018 ; Senna et al, 2019 ; Shen et al, 2019 ; Eltabl et al, 2020 ; Hashim et al, 2020 ; Chen et al, 2021b ), including 436 participants, met the selection criteria and were included in this meta-analysis. The flow diagram involved in the current study is shown in Figure 1 .…”

“…The main characteristics and preparations of PRP injection among the eight included RCTs are shown in Tables 1 , 2 . In these enrolled studies, three studies were conducted in Egypt ( Senna et al, 2019 ; Eltabl et al, 2020 ; Hashim et al, 2020 ), and three studies in China ( Wu et al, 2017 ; Shen et al, 2019 ; Chen et al, 2021b ), each one in Iran ( Raeissadat et al, 2018 ) and Greece ( Malahias et al, 2018 ). In these included studies, CTS patients were treated with local autologous PRP injection in the experimental group and different types of conservative treatment in the control group.…”