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

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 (NZ26) 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 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. (C) 2021 by the American Congress of Rehabilitation Medicine