Platelet‐rich plasma ultrasound‐guided injection in the treatment of carpal tunnel syndrome: A placebo‐controlled clinical study

Abstract

The purpose of this study is to demonstrate whether and to what extent a single injection of platelet-rich plasma (PRP), under ultrasound guidance, can improve the clinical symptoms of patients with a mild to moderate carpal tunnel syndrome (CTS). We conducted a prospective, randomized, clinical study including 50 patients suffering from mild to moderate CTS for a minimum duration of 3 months. Patients were randomly divided into 2 groups: Group A (26 patients) received an ultrasound-guided PRP injection into the carpal tunnel, whereas Group B (24 patients) was injected with placebo (0.9% normal saline). The short- and mid-term outcomes were determined with the use of the Q-DASH questionnaire and the pain scale VAS administered at 0, 4, and 12 weeks follow-up. The success ratio was determined by the difference in the Q-DASH obtained pre-injection minus the final Q-DASH obtained after 12 weeks follow-up. Success was defined as a difference more than 25%. Group A patients demonstrated a 76.9% success as determined by the difference Q-DASH, whereas Group B patients demonstrated 33.3% success, which was significantly less than Group A (Χ , p = .011). The findings of this study suggest that a single PRP ultrasound-guided injection has positive effects in patients with CTS.

Comparison of perineural platelet‐rich plasma and dextrose injections for moderate carpal tunnel syndrome: A prospective randomized, single‐blind, head‐to‐head comparative trial

“…In 2017, Wu et al (2017) found that perineural PRP injection produced noteworthy reductions in pain and disability, as well as CSA of the MN, compared with night splinting at 6 months posttreatment in patients with mild‐to‐moderate CTS. In 2018, the first double‐blind placebo‐controlled trial also revealed a positive effect of PRP for mild‐to‐moderate CTS with a 3‐month follow‐up period, compared with normal saline injection (Malahias et al, ). The results of the present study validate and expand upon these previous findings to demonstrate the clinical utility of perineural PRP injection as a treatment option for CTS.…”

Regenerative Injections Including 5% Dextrose and Platelet-Rich Plasma for the Treatment of Carpal Tunnel Syndrome: A Systematic Review and Network Meta-Analysis

“…Of the ten included studies, three compared PRP with corticosteroid injection [27,30,32], one compared PRP with saline injection [28], three compared PRP injection (with or without additional splinting) with splinting alone [23,29,33], one [34] compared D5W with saline injection, one [22] compared D5W with corticosteroid injection, and one [31] compared PRP with D5W injection. With respect to outcome assessment, the Boston Carpal Tunnel Questionnaire (BCTS) was used in nine [22,23,27,[29][30][31][32][33][34] of the ten enrolled studies.…”

“…With respect to outcome assessment, the Boston Carpal Tunnel Questionnaire (BCTS) was used in nine [22,23,27,[29][30][31][32][33][34] of the ten enrolled studies. The visual analogue scale (VAS) for pain was used as a surrogate for the symptom severity scale (SSS) in one trial [28]. In terms of the injection technique, seven studies [22,23,28,30,31,33,34] used ultrasound guidance, whereas three [27,29,32] employed palpation guidance.…”

“…The visual analogue scale (VAS) for pain was used as a surrogate for the symptom severity scale (SSS) in one trial [28]. In terms of the injection technique, seven studies [22,23,28,30,31,33,34] used ultrasound guidance, whereas three [27,29,32] employed palpation guidance. The maximal follow-up duration was 24 weeks in five trials [22,[31][32][33][34], 12 weeks in three trials [27,28,30], 10 weeks in one trial [29], and four weeks in one trial [23].…”

“…Three studies were further discarded because one was a conference proceeding without retrievable data [24], one was a case report [25], and the other was a case series without a control group [26]. Therefore, ten studies were included in the final quantitative analysis (Figure 1) [22,23,[27][28][29][30][31][32][33][34].…”