The Long-Term Analgesic Effectiveness of Platelet-Rich Plasma Injection for Carpal Tunnel Syndrome: A Cross-Sectional Cohort Study

Abstract

Objective Interest in perineural platelet-rich-plasma (PRP) injections for the treatment of carpal tunnel syndrome (CTS) has increased in recent years. However, evidence supporting the long-term effectiveness of PRP is lacking. Therefore, the aim of our cross-sectional cohort study was to investigate the long-term results of PRP injections for CTS. Methods Eighty-one patients diagnosed with CTS of any grade who received a single PRP injection at least 2 years prior were enrolled. Through structured telephone interviews, all patients were asked of their post-injection outcomes compared to their pre-injection condition. Symptom relief ≥50%, compared to the pre-injection condition, was considered an effective outcome. Binary logistic regression was applied to analyze each baseline variable as a regressor for determining the prognostic outcome factors. Results In total, 70% of patients reported positive outcomes ≥2 years post-injection. Shorter duration of symptoms before treatment (odds ratio: 0.991; 95% confidence interval [CI] 0.983–0.999; p = 0.023) and lower electrodiagnostic severity of CTS were the main prognostic factors for an effective outcome (mild grade vs. severe grade, odds ratio: 17.652; 95% CI 1.43–221.1; p = 0.025). Although there was a trend toward positive outcomes at longer follow-up durations (2–3 years vs. 3–4 years vs. 4–5 years), the difference was not statistically significant. Conclusion A single perineural PRP injection has a long-term analgesic effect on CTS, especially in mild-to-moderate cases.

The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study

“…In this data collection, exclusively from those that failed surgery, more treatment sessions (a mean of 3.1) were required to reach an effective outcome. We defined an effective outcome as symptom relief ≥ 50% compared to pre-injection, based on our previous studies [17,24]. This criterion for an effective outcome is higher than the minimal clinical important difference (MCID) of VAS which is a minimum decrease of 2 points [45] or a 25% reduction pain intensity [46].…”

“…Structured telephone interviews began in April 2022, conducted by the same research assistant as in previous retrospective studies [17,24]. The investigator asked all patients about the percentage of symptom relief of their affected hand(s) (digital pain severity, paresthesia, or dysesthesia associated with CTS) post-injection compared to pre-injection using VAS as in previous studies [17,24].…”

“…Structured telephone interviews began in April 2022, conducted by the same research assistant as in previous retrospective studies [17,24]. The investigator asked all patients about the percentage of symptom relief of their affected hand(s) (digital pain severity, paresthesia, or dysesthesia associated with CTS) post-injection compared to pre-injection using VAS as in previous studies [17,24]. We categorized the patient-reported outcomes as follows: (1) Symptom relief ≥ 70% as an excellent outcome, (2) Symptom relief ≥ 50% but <70% as a good outcome, (3) Symptom relief ≥ 30% but <50% as slight improvement, (4) Symptom relief < 30% as no change, and (5) Symptom worse than pre-injection as a worse outcome.…”

“…We categorized the patient-reported outcomes as follows: (1) Symptom relief ≥ 70% as an excellent outcome, (2) Symptom relief ≥ 50% but <70% as a good outcome, (3) Symptom relief ≥ 30% but <50% as slight improvement, (4) Symptom relief < 30% as no change, and (5) Symptom worse than pre-injection as a worse outcome. Only excellent or good outcomes were considered effective outcomes; otherwise, patients were rated as having poor outcomes [17,24]. For patients with bilateral CTS, only the most symptomatic side was recorded for the analysis.…”

Efficacy of a Novel Intra-Articular Administration of Platelet-Rich Plasma One-Week Prior to Hyaluronic Acid versus Platelet-Rich Plasma Alone in Knee Osteoarthritis: A Prospective, Randomized, Double-Blind, Controlled Trial

“…Third, PRP composition, including concentrations of platelets, white blood cells, and levels of cytokine/growth factors was not measured in our study. Although PLTenus Plus Platelet Concentrate Separator has been widely used in published studies [ 28 , 29 , 60 ], this limitation should be considered with caution. Fourth, even though all syringes were identical, the operator administering the injections was able to identify the injectate; this was attributed to differences in tactile sensation when depressing the plunger for the injection of HA versus normal saline.…”