Endoscopic transcarpal ligament release combine with platelet-rich plasma for carpal tunnel syndrome

Chin-Wei Hsiao ； Jui-Tien Shih

《Formosan Journal of Musculoskeletal Disorders》 10卷3期 (2019/08) Pp. 106-114

https://doi.org/10.6492/FJMD.201908_10(3).0003

摘要

Background: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy and is generally treated first by conservative measures. However, these measures generally do not result in satisfactory outcomes. Recently, there has been an increasing research attention on platelet-rich plasma (PRP) for its potential effects on axonal regeneration and neurological recovery. Purpose: Although few studies have to analyze effects of PRP treatment in CTS, there is a need for further investigation to reach a concrete conclusion. Methods: This randomized controlled trial selected patients referring to the hand clinic at our hospital during 2018 with a diagnosis of mild and moderate idiopathic CTS. These patients were randomly assigned to the following two groups: a control group (I) that underwent only endoscopic carpal tunnel release surgery and a PRP group (II) that received endoscopic carpal tunnel release surgery and a single local injection of PRP during surgery. The outcome measures were assessed by the visual analog scale, the Boston Carpal Tunnel Syndrome Questionnaire, and electrophysiological findings, including the peak latency of sensory nerve action potential and the onset latency of the compound muscle action potential. A total of 36 patients (6 males and 30 females) were included (18 wrists as the control group, of which 8 wrists were mild and the remaining 10 were of moderate stage, and 18 wrists as the PRP group, of which 8 wrists were mild and the remaining 10 were of moderate stage). Results: Before treatment, there were no significant differences between the two groups, except for the median peak latency of sensory nerve action potential that was significantly higher among patients in the PRP group (p = 0.03). After 12 weeks of treatment, all the measured variables significantly increased in both groups. Finally, the changes in nerve study of the evaluated outcome measures were found to the significantly different between the two groups with moderate-stage patients. Conclusion: This is study demonstrated that with in a relatively short period of time after treatment, a single injection of PRP could result in faster recovery in wrists with moderate severity than that in wrists that received only the endoscopic carpal tunnel release surgery.

關鍵字

carpal tunnel syndrome ； endoscopic surgery ； platelet-rich plasma