Abstract
Objective
To compare the short-term effectiveness of corticosteroids, 5% dextrose(D5W), and
platelet-rich plasma (PRP) injections for treating carpal tunnel syndrome (CTS).
Data sources
Four databases (MEDLINE (PubMed), Embase, the Cochrane Controlled Trials Register,
and Web of Science (WOS)) were researched from inception to the 1st of April 2022.
Study selection
Two authors independently screened the literature to identify the RCTs meeting the
included criteria, which involved comparing corticosteroid, 5% dextrose water (D5W),
and platelet-rich plasma (PRP) injection with each other or placebo-controlled for
treating CTS.
Data extraction
The two reviewers independently conducted information extraction, the outcomes included
were the changes in Symptom Severity Scale (SSS), Function Status Scale (FSS), and
Visual Analogue Scale (VAS) at short-term follow-up after drug injection treatment
and any adverse events reported.
Data synthesis
Twelve randomized controlled trials with 749patients (817 hands) were included. The
results of this study suggested that PRP injection was the most likely to relieve
symptoms, improve functions and alleviate pain, with the SUCRA being 91.5%, 92.7%,
and 80.8%, respectively, followed by D5W injection (74.4%, 72.2%, 72.1%), and corticosteroid
injection (33.7%, 31.9%, 46.2%). The injection of three drugs was significantly better
than that of a placebo.
Conclusion
From the results of the network meta-analysis, PRP injection is the most recommended
treatment among the injection of corticosteroid, D5W, and PRP.
The protocol of this network meta-analysis has been registered in PROSPERO with registration
number CRD42022325228.
Keywords
List of abbreviations:
CTS (Carpal tunnel syndrome, SSS, Symptom Severity Scale, FSS, Function Status Scale), VAS (Visual Analogue Scale), D5W (5% dextrose water), PRP (Platelet-rich plasma), NMA (Network Meta-analysis), SMD (Standardized mean difference), 95% CI (95% confidence interval), IF (Inconsistency factor), SUCRA (Surface under the cumulative ranking curve)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
November 22,
2022
Received in revised form:
November 14,
2022
Received:
July 26,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
