A single perineural platelet-rich-plasma (PRP) injection was found to have a long-term analgesic effects among most patients with mild to moderate carpal tunnel syndrome (CTS), according to a study published in Pain Medicine.
Patients (N=81) with CTS who received a single ultrasound-guided perineural PRP injection from a single physician between 2015 and 2018 were recruited for this study. Patients were contacted by telephone and underwent a structured interview evaluating their symptoms using the visual analog scale and Boston Carpal Tunnel Syndrome Questionnaire.
Patients received PRP derived using either the RegentKit ® THT-1 (n=61) or PLTenus Plus (n=20). The RegentKit and PLTenus cohorts were 85.2% and 90.0% women, aged mean 55.2±1.4 and 56.1±1.9 years, 54.1% and 55.0% had right-sided CTS, the duration of symptoms was 59.5±10.2 and 53.8±10.1 months, 14.8% and 15.0% had mild symptoms, 75.4% and 65.0% moderate symptoms, and 9.8% and 20.0% severe symptoms, respectively.
Most patients (n=57) reported a favorable outcome. Patients who had poor outcomes had a longer duration of symptoms (mean, 87.3 vs 45.8 months; P =.003), more had severe symptoms (25.0% vs 7.0%; P =.038), and they were taller (mean, 160.9 vs 157.8 cm; P =.044).
An effective outcome was associated with mild Padua classification (odds ratio [OR], 17.652; 95% CI, 1.43-221.1; P =.025). Inverse relationships between an effective outcome and duration of symptoms (OR, 0.991; 95% CI, 0.983-0.999; P =.023) and height (OR, 0.926; 95% CI, 0.860-0.996; P =.040) were observed.
A receiver operating characteristic curve analysis found that a 43.5-month cutoff value for duration of symptoms had a sensitivity of 71.9%, specificity of 58.3%, and area under the curve of 0.706 for predicting outcomes.
It is possible that the efficacy of single perineural PRP injection may be overestimated in this study due to lack of a control cohort.
This study found evidence that a single perineural PRP injection had long-term analgesic effects among patients with CTS. Patients who had shorter-term, mild CTS were more likely to benefit from this therapy.
Lai C-Y, Li T-Y, Lam KHS, et al. The long-term analgesic effectiveness of platelet-rich plasma injection for carpal tunnel syndrome: a cross-sectional cohort study.Pain Med. 2022;pnac011. doi:10.1093/pm/pnac011