Ultrasound-guided PRP Versus Steroid Injections in Management of Carpal Tunnel Syndrome

Study Overview
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Brief Summary
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Patients will be randomly divided into 3 equal groups: Group I received ultrasound guided injection of 2 mL PRP into the affected carpal tunnel. Group II received ultrasound guided injection of 2 mL steroids (40 mg triamcinolone acetonide). Group III received ultrasound guided injection of 2 mL saline as placebo control.

Detailed Description
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Patients will be randomly divided into 3 equal groups: Group I received ultrasound guided injection of 2 mL PRP into the affected carpal tunnel. Group II received ultrasound guided injection of 2 mL steroids (40 mg triamcinolone acetonide). Group III received ultrasound guided injection of 2 mL saline as placebo control. Each group will be injected twice with 2 weeks intervals. All procedures were done after informed consent. Evaluation of the patients at baseline, 3 and 6 months after last injection was done clinically by measuring visual analogue scale (VAS), electrophysiologically (by measuring motor and sensory nerve conduction studies of median nerve using a standardized technique) and ultrasonographic study by measuring cross sectional area (CSA) of median nerve at the level of pisiform.

Official Title
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Ultrasound-guided PRP Versus Steroid Injections in Management of Carpal Tunnel Syndrome; a Comparative Study

Conditions
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Carpal Tunnel Syndrome

Intervention / Treatment
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* Drug: platlet rich plasma (PRP)
* Drug: Triamcinolone Acetonide
* Drug: Saline


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: mild or moderate idiopathic CTS (diagnosed clinically, ultrasonography & electrophysiologically and classified according to the American Association of neuromuscular diagnostic medicine monograph). Exclusion Criteria: Patients with severe or secondary type of CTS

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PRP group<br>patients received ultrasound-guided injection of 2 mL PRP into the affected carpal tunnel.patients will be injected twice with 2 weeks intervals | Drug: platlet rich plasma (PRP)<br>* Platelet-rich plasma (PRP) promotes angiogenesis, neurogenesis, and nerve regeneration, also it could reduce swelling and inflammation of the flexor tenosynovitis.<br>|
| Active Comparator: Steroid group<br>patients received ultrasound-guided injection of 2 mL steroids (40 mg triamcinolone acetonide). into the affected carpal tunnel. patients will be injected twice with 2 weeks intervals | Drug: Triamcinolone Acetonide<br>* 40 mg triamcinolone acetonide<br>|
| Placebo Comparator: Control group<br>patients received ultrasound-guided injection of 2 mL saline patients will be injected twice with 2 weeks intervals | Drug: Saline<br>* Saline<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| visual analogue scale | Scale for assessement the degree of pain along 0-10 scale | Change from 3 months after last injection and 6 months after last injection | 
| measuring motor and sensory nerve conduction studies of median nerve using a standardized technique | electrophysiologically by measuring motor and sensory nerve conduction studies of median nerve using a standardized technique | Change from 3 months after last injection and 6 months after last injection | 
| cross-sectional area (CSA) of the median nerve at the level of the pisiform. | ultrasonographic study by measuring cross-sectional area (CSA) of the median nerve at the level of the pisiform. | Change from 3 months after last injection and 6 months after last injection | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CTS, PRP injection, Local injection