Efficacy of Ultrasound-Guided Injection of Platelet-Rich Plasma in Triangular Fibrocartilage Complex Tear: A Preliminary Report

Purpose: To evaluate the efficacy of ultrasound (US)-guided injection of platelet-rich plasma (PRP) in a triangular fibrocartilage complex (TFCC) tear using the Patient-Rated Wrist Evaluation (PRWE) score.

Methods and Materials: The current preliminary report of this prospective interventional study approved by the institutional review board was composed of 12 patients with a TFCC tear diagnosed on magnetic resonance imaging. Under ultrasonographic guidance, 3 to 4 mL PRP was injected around the TFCC tear. The patients were subsequently evaluated using the PRWE score at 4 and 8 weeks. Data analysis was done with SPSS v.21.0 using the Wilcoxon test for comparing quantitative variables and the McNemar test for correlating qualitative variables. A p < 0.05 was considered statistically significant.

Results: The PRWE score showed a significantly decreasing trend in the present sample size. The mean ± standard deviation (SD) at 4 weeks was 55.83 ± 9.96 with an interquartile range (IQR) of 50 to 60 and a p value of 0.003. The mean ± SD PRWE score at 8 weeks was 26.67 ± 7.78 with IQR of 20 to 30 and p value of 0.003.

Conclusion: The clinical response of US-guided targeted PRP injection around a TFCC tear showed very encouraging results in this preliminary study. Our ongoing study will widen the database to further substantiate our preliminary results.

Fig. 1 Longitudinal ultrasound of ulnocarpal region demonstrates horizontal tear in the triangular fibrocartilage complex (yellow arrow). Blue asterisk indicates ulna; red asterisk, triquetrum; and green arrow, extensor carpi ulnaris tendon.

Fig. 2 Longitudinal ultrasound of the ulnocarpal region demonstrates injection of platelet-rich plasma around the triangular fibrocartilage complex tear. Yellow arrow shows the needle trajectory.

Fig. 3 Longitudinal ultrasound of the ulnocarpal region demonstrates healed triangular fibrocartilage complex (TFCC) tear 8 weeks after platelet-rich plasma injection. Yellow arrow indicates the TFCC.

Fig. 4 Graph of the Patient-Rated Wrist Evaluation (PRWE) score demonstrates decreasing trend at 4 weeks and 8 weeks after platelet-rich plasma injection.

 

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Publikationsverlauf

Artikel online veröffentlicht:
17. Dezember 2020