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J Tissue Eng Regen Med. 2019 Jul 31. doi: 10.1002/term.2950. [Epub ahead of print]

Comparison of perineural platelet-rich plasma and dextrose injections for moderate carpal tunnel syndrome: A prospective randomized, single-blind, head-to-head comparative trial.

Shen YP1,2, Li TY1,2,3, Chou YC4, Ho TY1,2, Ke MJ1,5, Chen LC1,2, Wu YT1,2,3.

Author information

1
Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taiwan, Republic of China.
2
School of Medicine, National Defense Medical Center, Taiwan, Republic of China.
3
Integrated Pain Management Center, Tri-Service General Hospital, Taiwan, Republic of China.
4
School of Public Health, National Defense Medical Center, Taiwan, Republic of China.
5
Force Rehabilitation Clinic, Taiwan, Republic China.

Abstract

Recent studies demonstrated the utility of perineural injection with platelet-rich plasma (PRP) and 5% dextrose (D5W) as novel strategies for treatment of carpal tunnel syndrome (CTS). The present study comprised a prospective, randomized, single-blind, head-to head comparative trial to compare the 6-month outcome of perineural injection with PRP or D5W in patients with moderate CTS. Fifty-two patients with unilateral moderate CTS were enrolled and randomized into two groups: The PRP group received a single 3-cc perineural injection of PRP under ultrasound guidance, and dextrose group received a single 3-cc perineural injection of D5W under ultrasound guidance. The Boston Carpal Tunnel Syndrome Questionnaire score was used as the primary outcome. Secondary outcomes included cross-sectional area (CSA) of the median nerve and electrophysiological assessments. Evaluations were performed at baseline and at 1, 3, and 6 months postinjection. All patients (26 patients per group) completed the study. Compared with the dextrose group, the PRP group demonstrated significant reductions in Boston Carpal Tunnel Syndrome Questionnaire function at 3 months (p = .044), distal motor latency at 6 months (p = .028), and CSA at 3 and 6 months (p = .010 and.018, respectively). A single perineural injection of PRP reduced the CSA of the median nerve more effectively than injection of D5W at 3 and 6 months postinjection for patients with moderate CTS.

KEYWORDS:

carpal tunnel syndrome; dextrose; perineural injection; peripheral nerve entrapment; platelet-rich plasma; regenerative

PMID:
31368191
DOI:
10.1002/term.2950

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