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One-Year Efficacy of Platelet-Rich Plasma for Moderate-to-Severe Carpal Tunnel Syndrome: A Prospective, Randomized, Double-Blind, Controlled Trial

  • Si-Ru Chen
    Affiliations
    Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Yu-Ping Shen
    Affiliations
    Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Tsung-Yen Ho
    Affiliations
    Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China

    Department of Physical Medicine and Rehabilitation, Taichung Armed Forces General Hospital, Taichung City, Taiwan, Republic of China
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  • Tsung-Ying Li
    Affiliations
    Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China

    Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Yu-Chi Su
    Affiliations
    Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Yu-Ching Chou
    Affiliations
    School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Liang-Cheng Chen
    Affiliations
    Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Yung-Tsan Wu
    Correspondence
    Corresponding author Yung-Tsan Wu, MD, Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu District, Taipei, Taiwan, Republic of China.
    Affiliations
    Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China

    Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Published:February 03, 2021DOI:https://doi.org/10.1016/j.apmr.2020.12.025

      Abstract

      Objective

      To assess the therapeutic effect of platelet-rich plasma (PRP) for moderate-to-severe carpal tunnel syndrome (CTS).

      Design

      A prospective, randomized, double-blinded, controlled trial (1-year follow-up).

      Setting

      Outpatient of local medical center settings.

      Participants

      Patients (N=26) who were diagnosed with bilateral moderate-to-severe CTS (total 52 wrists) were included. For each patient, one wrist was randomized into either the PRP or control group and the contralateral wrist of the same patient was allocated to another group.
      Twenty-four patients were included in the final data analysis.

      Interventions

      The wrists in the PRP group received a single ultrasound-guided dose of PRP injection (3.5mL), and the control group received a single ultrasound-guided injection with normal saline (3.5mL).

      Main Outcome Measures

      The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores were used as the primary outcome. Secondary outcomes encompassed the cross-sectional area of the median nerve and electrophysiological study. Assessments were conducted prior to injection and 1, 3, 6, and 12 months postinjection.

      Results

      Compared to the control group, the PRP group exhibited significant improvements in BCTQ severity scores at all time points, BCTQ functional scores at the sixth month, and cross-sectional area at the 12th month postinjection (P<.0125).

      Conclusions

      A single dose of ultrasound-guided perineural PRP injection can provide therapeutic effect for 1 year postinjection.

      Keywords

      List of abbreviations:

      BCTQ (Boston Carpal Tunnel Syndrome Questionnaire), CSA (cross-sectional area), CTS (carpal tunnel syndrome), DML (distal motor latency), FSS (functional status scale), MCID (minimal clinically important difference), NS (normal saline), PRP (platelet-rich plasma), SNCV (sensory nerve conduction velocity), SSCT (subsynovial connective tissue), SSS (symptom severity scale)
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