Abstract:

The prevalence of arthrosis of the thumb carpometacarpal (CMC) joint is 35.8% in older males and females. In our study, it was aimed to compare the effect of corticosteroid and platelet-rich plasma (PRP) injection on the clinical and functional results in arthrosis of the first carpometacarpal joint of the hand. Materials and Methods: 58 patients who presented to our clinic between October 2016 - March 2018 and were diagnosed with osteoarthritis of the first carpometacarpal joint of the hand, who did not previously benefit from other conservative treatment methods, who were stage 2 according to the Eaton-Littler classification and followed-up for at least 24 weeks were enrolled in this prospective study. Dreiser and VAS scores at months 1, 2, 3 and 6 were evaluated and the results were statistically compared. Results: There was no statistically significant difference between the groups in terms of pre-injection VAS and Dreiser scores (p=0.211 and p=0.239, respectively). The difference between the clinical scores before the injection and at weeks 4, 8, 12 and 24 within each group was statistically significant, wherein the improvement in VAS and Dreiser scores was at a statistically significant level (p<0.001). It was observed that both groups showed an improvement in VAS and Dreiser scores and the clinical results of the two groups were similar at week 24. Although the amount of functional improvement and pain had decreased at week 24, VAS and Dreiser scores exhibited a statistically significant decrease in comparison to the pre-injection period (p<0.05). Conclusion: Comparing PRP and steroid injections, it was observed that the improvement in hand functions according to the Dreiser score and the decrease in the level of pain according to the VAS score at week 24 were similar in both methods, and there was no statistically significant difference between them. In the light of current data, although the effectiveness of PRP has been proven in osteoarthritis of the first CMC joint, replacing the steroid treatment with PRP seems difficult due to drawbacks such as the challenging preparation period, higher costs and difficulty of supplying the sets.

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