Platelet-Rich Plasma Ultrasound-Guided Injection in the Treatment of Carpal Tunnel Syndrome: A Placebo-Controlled Clinical Study

Doctoral Dissertation uoadl:2775124 137 Read counter

Τομέας Χειρουργικής
Library of the School of Health Sciences
Deposit date:
Μalachias Michail-Alexandros
Dissertation committee:
Παπαγγελόπουλος Παναγιώτης, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Γεώργιος Μπάμπης, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Τζόνσον Ελισάβετ-Ουρανία, Ομότιμη Καθηγήτρια, Ιατρική, ΕΚΠΑ
Κελέκης Χρυσόστομος-Αλέξης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Χρονόπουλος Ευστάθιος, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Νικολάου Βασίλειος, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Μαυρογένης Ανδρέας, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Η υπερηχογραφικά καθοδηγούμενη έγχυση αυτόλογου πλάσματος αίματος εμπλουτισμένου σε αιμοπετάλια ως πιθανή θεραπευτική λύση στις περιφερικές νευροπάθειες: το παράδειγμα του συνδρόμου καρπιαίου σωλήνα
Translated title:
Platelet-Rich Plasma Ultrasound-Guided Injection in the Treatment of Carpal Tunnel Syndrome: A Placebo-Controlled Clinical Study
Background: Based on the most recent literature platelet-rich plasma (PRP) ultrasound-guided injections around affected neural tissues could be a promising biologic-repairing treatment, which might change the natural history of the neuropathic diseases. Autogeneic neurotrophic growth factors included into the PRP, in combination with the mechanical hydrodissolution of the median nerve during the guided perineural injection, remain to be further investigated in the clinical field as far as their possible therapeutic effect in patients with CTS.
Purpose: To demonstrate whether and to what extent a single injection of Platelet-Rich Plasma (PRP), under ultrasound guidance, can improve the clinical symptoms of patients with a mild to moderate carpal tunnel syndrome (CTS).
Materials & Methods: We conducted a prospective, randomized, controlled, double-blind single-center clinical study including 50 patients suffering from mild to moderate CTS for a minimum duration of 3-month duration. Patients were randomly divided into two groups: Group A (26
patients) received an ultrasound-guided PRP injection into the carpal tunnel, whereas Group B (24 patients) was injected with placebo (0.9% normal saline, N/S). The short and mid-term outcomes were determined with the use of the Q-DASH questionnaire and the pain scale VAS administered at 0, 4, 12 weeks follow-up. After the initial power analysis, data were assessed using t-test and chi square test (p<0.05), accordingly. The success ratio was determined by the difference in the Q-DASH obtained pre-injection minus the final Q-DASH obtained after 12 weeks follow-up. Success was defined as a difference more than 25%.
Results: Our power analysis was estimated 83%. Group A patients demonstrated a 76.9% success as determined by the difference Q-DASH, while group B patients demonstrated 33.3% success, which was significantly less than group A (X²=0.011, p<0.05).
Conclusion: The findings of the present study suggest that a single PRP ultrasound-guided injection has positive effects in patients with carpal tunnel syndrome.
Main subject category:
Health Sciences
Platelet-rich Plasma (PRP), Ultrasound-guided injection, Carpal tunnel syndrome, Interventional treatment, Nerve entrapment syndromes, Randomized double-blind placebo-controlled clinical trial
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