Efficacy of platelet-rich plasma injection versus other conservative treatments of carpal tunnel syndrome: A meta-analysis

Objective: Injection of platelet-rich plasma (PRP) as a proposed treatment for carpal tunnel syndrome (CTS) is a recent innovation. The aim of this analysis is to evaluate the functional and objective outcomes after PRP injection versus other conservative treatments of CTS. Methods: We systematically searched the electronic databases for trials that met our inclusion criteria. Two reviewers screened the studies, extracted the data, evaluated the methodological quality, and performed data analysis. Subgroup analysis was stratified by the follow-up periods. Results: Five randomized controlled trials (RCTs) and one prospective cohort trial met the inclusion criteria. A total of 318 subjects were reported including 160 with PRP injection and 158 with other conservative treatments. The quality of the included studies was high. The meta-analysis showed that no significant differences were detected in the visual analog scale (VAS), the Boston Carpal Tunnel Syndrome Questionnaire-the syndrome (BCTQ-S) and the Boston Carpal Tunnel Syndrome Questionnaire-the functional status (BCTQ-F) at 6 months, changes of VAS, BCTQ-S and BCTQ-F, distal motor latency (DML) and sensory conduction velocity (SCV) between the PRP injection and other conservative treatments. However, the BCTQ-S and BCTQ-F score at 3 months of PRP injection were significantly lower than other conservative treatments. Conclusion: Current evidence revealed that there were no significant differences between PRP injection and other conservative treatment in relief pain, improving clinical symptom and functional status and electrophysiological findings at the final follow up period. However, PRP injection could improve the clinical symptom and functional status at the early period (3 months) of treatment.