A recently published study by an orthopedic group in Greece has found potential benefit to using platelet rich plasma (PRP) injections over steroid for treating trapeziometacarpal joint (TMJ) osteoarthritis (OA). This location is the second most common in the hand for OA and can be significantly disabling by reducing thumb opposition and weakening pinch and grip strength as a result. The team noted positive findings for PRP use in arthritis in multiple recent studies and decided to trial the same treatment in TMJ arthritis compared to the standard steroid injection.
The study was a prospective, randomized, comparative, blinded clinical study of 33 patients. The injections were performed under ultrasound guidance and used either 2mL of leukocyte-poor, nonactivated PRP with 2.6 times higher concentration of platelets or 2mL of methylprednisolone and lidocaine. The patients were followed up at three and 12 months for overall improvement in their symptoms and function. No additional advice was given about other activities during the recovery period.
At three months, no significant difference was noted in pain with both groups improved, but that improvement was only sustained to 12 months in the PRP group. With regards to function, both groups were similar at three months, but those with steroid had returned to baseline at 12 months while those injected with PRP continued to improve. Satisfaction amongst patients was higher with steroid at three months, but higher in the PRP group at 12 months reflecting their decreased pain and better function.
The data indicate that PRP may be a better alternative to treatment of thumb base OA than steroid. The authors point out that there has been some interest in use of hyaluronic acid (HA) for this condition with some positive results and believe that comparison between PRP and HA would be a useful next step in determining optimal treatment for this condition.
To download or read the publication: https://www.pubfacts.com/detail/30343590/Platelet-Rich-Plasma-versus-Corticosteroid-Intra-Articular-Injections-for-the-Treatment-of-Trapeziom