Leukocyte-Reduced Platelet-Rich Plasma Treatment of Basal Thumb Arthritis: A Pilot Study

A positive effect of intra-articular platelet-rich plasma (PRP) injection has been discussed for osteoarthritic joint conditions in the last years. The purpose of this study was to evaluate PRP injection into the trapeziometacarpal (TMC) joint. We report about ten patients with TMC joint osteoarthritis (OA) that were treated with 2 intra-articular PRP injections 4 weeks apart. PRP was produced using the Double Syringe System (Arthrex Inc., Naples, Florida, USA). A total volume of 1.47 ± 0.25 mL PRP was injected at the first injection and 1.5 ± 0.41 mL at the second injection, depending on the volume capacity of the joint. Patients were evaluated using VAS, strength measures, and the Mayo Wrist score and DASH score after 3 and 6 months. VAS significantly decreased from 6.2 ± 1.6 to 5.4 ± 2.2 at six-month follow-up (P < 0.05). The DASH score was unaffected; however, the Mayo Wrist score significantly improved from 46.5 ± 18.6 to 67.5 ± 19.0 at six-month follow-up (P = 0.05). Grip was unaffected, whereas pinch declined from 6.02 ± 2.99 to 3.96 ± 1.77 at six-month follow-up (P < 0.05). We did not observe adverse events after the injection of PRP, except one occurrence of a palmar wrist ganglion, which resolved without treatment. PRP injection for symptomatic TMC OA is a reasonable therapeutic option in early stages TMC OA and can be performed with little to no morbidity.

[1]  I. Martin,et al.  Cartilage Repair in the Inflamed Joint: Considerations for Biological Augmentation Toward Tissue Regeneration. , 2016, Tissue engineering. Part B, Reviews.

[2]  V. Valderrábano,et al.  The effect of leukocyte-reduced platelet-rich plasma on the proliferation of autologous adipose-tissue derived mesenchymal stem cells. , 2016, Clinical hemorheology and microcirculation.

[3]  C. Colak,et al.  Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial , 2017, Knee Surgery, Sports Traumatology, Arthroscopy.

[4]  J. Dragoo,et al.  The Effect of Platelet-Rich Plasma Formulations and Blood Products on Human Synoviocytes , 2014, The American journal of sports medicine.

[5]  M. Marcacci,et al.  Comparison of platelet-rich plasma formulations for cartilage healing: an in vitro study. , 2014, The Journal of bone and joint surgery. American volume.

[6]  N. Maffulli,et al.  Platelet-rich plasma for managing pain and inflammation in osteoarthritis , 2013, Nature Reviews Rheumatology.

[7]  N. Marwaha,et al.  Treatment With Platelet-Rich Plasma Is More Effective Than Placebo for Knee Osteoarthritis , 2013, The American journal of sports medicine.

[8]  M. Lenza,et al.  Platelet-rich therapies for musculoskeletal soft tissue injuries. , 2013, The Cochrane database of systematic reviews.

[9]  G. Abrams,et al.  Hyaluronic Acid and Platelet-Rich Plasma, Intra-articular Infiltration in the Treatment of Gonarthrosis: Letter to the Editor , 2013, The American journal of sports medicine.

[10]  Gorka Orive,et al.  A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. , 2012, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[11]  S. Goldring,et al.  Osteoarthritis: a disease of the joint as an organ. , 2012, Arthritis and rheumatism.

[12]  J. Dragoo,et al.  Contents and Formulations of Platelet Rich Plasma , 2012 .

[13]  W. Marsden I and J , 2012 .

[14]  M. Marcacci,et al.  Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach , 2012, Knee Surgery, Sports Traumatology, Arthroscopy.

[15]  F. Berenbaum,et al.  Osteoarthritis: an update with relevance for clinical practice , 2011, The Lancet.

[16]  D. Gnatenko,et al.  The platelet proteome , 2009, Current opinion in hematology.

[17]  E. Akelman,et al.  Thumb Carpometacarpal Arthritis , 2009 .

[18]  L. Ada,et al.  Surgery for thumb (trapeziometacarpal joint) osteoarthritis. , 2009, The Cochrane database of systematic reviews.

[19]  Paul D. Kim,et al.  Hylan versus corticosteroid versus placebo for treatment of basal joint arthritis: a prospective, randomized, double-blinded clinical trial. , 2008, The Journal of hand surgery.

[20]  S. Stahl,et al.  Comparison of Intraarticular Injection of Depot Corticosteroid and Hyaluronic Acid for Treatment of Degenerative Trapeziometacarpal Joints , 2005, Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases.

[21]  J. Patton,et al.  A randomised controlled trial of intra-articular corticosteroid injection of the carpometacarpal joint of the thumb in osteoarthritis , 2004, Annals of the rheumatic diseases.

[22]  R. Eaton,et al.  Splinting in the treatment of arthritis of the first carpometacarpal joint. , 1999, The Journal of hand surgery.

[23]  W P Cooney,et al.  Anatomy of trapeziometacarpal ligaments. , 1993, The Journal of hand surgery.

[24]  J. Littler,et al.  Ligament reconstruction for the painful thumb carpometacarpal joint. , 1973, The Journal of bone and joint surgery. American volume.