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

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.