Platelet-rich plasma in treatment of patients with idiopathic carpal tunnel syndrome
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Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper extremity. Treatments for CTS alternate from conservative strategies to surgical decompression of median nerve. Few studies have applied platelet-rich plasma (PRP) for treating idiopathic CTS, with acceptable success rates. Further studies are needed to reach concrete conclusion.
To study the effect of PRP injection in treatment of mild to moderate idiopathic CTS.
This is a randomized controlled trial in a cohort of Egyptian patients suffered from mild to moderate CTS. They were randomly divided into two groups. Group 1: patients received ultrasound guided PRP injection and group 2 patients received ultrasound guided corticosteroid injection. The outcome measures were assessed via Visual Analog Scale, the Boston Carpal Tunnel Syndrome Questionnaire, electrophysiological findings in sensory and motor functions of median nerve and morphological changes of median nerve detected by ultrasound.
This study included 150 patients suffered from mild to moderate idiopathic CTS 15 did not provide the written consent and 37 participants were excluded from the study based on the exclusion criteria leaving only 98 patients to participate in the study they were divided into two groups PRP Injection Group (PRP-inj-G) — this group included 49 patients (40 females and 9 males) steroid injection Group (St-inj-G) — included 49 patients (41 females and 8 males). At the beginning of study there was no significant difference between both groups in all parameters. (a) PRP injection had significantly improved the clinical manifestations, the electrodiagnostic examination (EDX) parameters of the median nerve (MN), and the median nerve cross sectional area (m-CSA) at 1 month and 3 months post-injection evaluation in comparison to baseline recordings; (b) local steroid injection had significantly improved the clinical manifestations, the EDX parameters of the MN, and the m-CSA at 1 month and 3 months post-injection evaluation in comparison to baseline recordings and (c) PRP injection was superior to the local steroid injection in the improvement of clinical manifestations as well as the MN motor conduction velocity along the wrist-elbow segment, the sensory latency (SL) and the MN sensory conduction, this superiority was observed in third month follow-up suggesting better outcomes in long-term follow-up.
Platelet-rich plasma could be effective treatment of mild to moderate idiopathic CTS and superior to corticosteroid in improving pain, function, and distal sensory latency of median nerve.
• PRP is effective treatment of mild to moderate CTS.
• PRP is superior to corticosteroids in improving pain and function in CTS.
KeywordsCarpal tunnel syndrome Corticosteroids Platelet rich plasma
Abductor pollicis brevis muscle
Boston carpal tunnel questionnaire
Boston carpal tunnel questionnaire functional status scale
Boston carpal tunnel questionnaire symptom severity scale
Carpal tunnel syndrome
Compound muscle action potential
Distal motor latency
Idiopathic carpal tunnel syndrome
Median cross sectional area
Platelet rich plasma
Randomized controlled trial
Sensory nerve action potential
Sensory nerve conduction velocity
Visual analog scale
All authors wish to express deep appreciation and gratitude to professor Mohammad K. for his support in statistical analysis of this work and great appreciation to all cooperative patients participated in this study.
All authors have contributed to the concept and design of the study, interpretation of the data and revising the manuscript, and have approved the final draft.
Dr. Mohammad k. Senna assessed EDX outcomes, Dr. Reham M. assessed US outcome and Dr. Alaa assessed clinical outcomes.
This study was totally funded by all authors. All authors are responsible for payment of publications fees. All authors declare that they did not receive any financial support.
Compliance with ethical standards
- 2.O'Connor D, Marshall S, Massy-Westropp N.(2003) Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev;(1):CD003219. ReviewGoogle Scholar
- 6.Marshall S, Tardif G, Ashworth N(2007) "Local corticosteroid injection for carpal tunnel syndrome." Cochrane Database Syst Rev;(2):Cd001554Google Scholar