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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(02): 200-206
DOI: 10.1055/s-0042-1744410
Hand/Peripheral Nerve
Original Article

Electromyographic and Clinical Investigation of the Effect of Platelet-Rich Plasma on Peripheral Nerve Regeneration in Patients with Diabetes after Surgery for Carpal Tunnel Syndrome

Tuğçe Yasak 
1   Department of Plastic Reconstructive and Aesthetic Surgery, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
,
Özay Özkaya 
2   Prof Dr. Özay Özkaya Private Clinic, Freelance Physician, Istanbul, Turkey
,
Ayça Ergan Şahin 
1   Department of Plastic Reconstructive and Aesthetic Surgery, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
,
Özlem Çolak 
1   Department of Plastic Reconstructive and Aesthetic Surgery, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
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Abstract

Background Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Studies have shown that results of CTS surgery are poorer in patients with diabetes. In this study, the effect of platelet-rich plasma (PRP) on nerve regeneration was investigated through clinical and electromyographic findings in patients with diabetes who underwent CTS surgery.

Methods A retrospective analysis of 20 patients with diabetes who had surgically decompressed CTS was conducted. Patients were divided into two groups. The study group received PRP treatment following surgery. The control group did not receive any treatment. Patients were assessed using electromyography and the Boston Carpal Tunnel Syndrome Questionnaire preoperatively as well as postoperatively at 3-month, 6-month, and 1-year follow-ups visits.

Results There was a decrease in complaints and an improvement in sensory and motor examinations in both groups. The Boston Carpal Tunnel Syndrome Questionnaire scores did not show any statistically significant differences between the two groups. However, electromyographic findings showed that there were statistical differences between preoperative and postoperative (3 months, 6 months, and 1 year) results in both groups. When the two groups were compared using preoperative and postoperative (3 months, 6 months, and 1 year) electromyographic values, no statistically significant differences were seen.

Conclusion Single injections of PRP did not have a significant impact on median nerve regeneration following CTS surgery in patients with diabetes. The effectiveness of multiple PRP injections can be investigated in patients with diabetes in future studies.

Keywords

diabetes mellitus - carpal tunnel syndrome - median nerve - nerve regeneration - platelet-rich plasma

Author Contributions

Conceptualization: T.Y., Ö.Ö., Ö.Ç. Data curation: A.E.Ş.,Ö.Ç. Formal analysis: T.Y., Ö.Ç. Methodology: T.Y., Ö.Ö., A.E.Ş. Project administration: A.E.Ş. Visualization: T.Y.,Ö.Ö. Writing-original draft: A.E.Ş. Writing-review and editing: T.Y.,Ö.Ç.


Ethical Approval

The study was approved by the institutional ethical committee (IRB #4668).


Patient Consent

Informed consent was obtained from all patients.




Publikationsverlauf

Artikel online veröffentlicht:
06. April 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Chammas M, Boretto J, Burmann LM, Ramos RM, Dos Santos Neto FC, Silva JB. Carpal tunnel syndrome - Part I (anatomy, physiology, etiology and diagnosis). Rev Bras Ortop 2014; 49 (05) 429-436
    Suche in Google Scholar
  • 2 Tekin F, Sürmeli M, Şimşek H. et al. Comparison of the histopathological findings of patients with diabetic and idiopathic carpal tunnel syndrome. Int Orthop 2015; 39 (12) 2395-2401
    CrossrefPubMedSuche in Google Scholar
  • 3 Singh R, Gamble G, Cundy T. Lifetime risk of symptomatic carpal tunnel syndrome in Type 1 diabetes. Diabet Med 2005; 22 (05) 625-630
    CrossrefPubMedSuche in Google Scholar
  • 4 de Krom MC, de Krom CJ, Spaans F. Carpal tunnel syndrome: diagnosis, treatment, prevention and its relevance to dentistry [in Dutch]. Ned Tijdschr Tandheelkd 2009; 116 (02) 97-101
    PubMedSuche in Google Scholar
  • 5 Lundborg G. Nerve Injury and Repair: Regeneration, Reconstruction, and Cortical Remodeling. London, England: Elsevier/Churchill Livingstone; 2004
    Suche in Google Scholar
  • 6 Taşpınar S, Şahin F, Erçalık C. et al. Comparison of the efficacy of corticosteroid injection, night splint and physiotherapy in diabetic carpal tunnel syndrome. Turk J Phys Med Rehabil 2007; 53 (02) 54-60
    Suche in Google Scholar
  • 7 Ozkul Y, Sabuncu T, Kocabey Y, Nazligul Y. Outcomes of carpal tunnel release in diabetic and non-diabetic patients. Acta Neurol Scand 2002; 106 (03) 168-172
    CrossrefPubMedSuche in Google Scholar
  • 8 Ebrahimzadeh MH, Mashhadinejad H, Moradi A, Kachooei AR. Carpal tunnel release in diabetic and non-diabetic patients. Arch Bone Jt Surg 2013; 1 (01) 23-27
    PubMedSuche in Google Scholar
  • 9 Albers JW, Brown MB, Sima AA, Greene DA. Tolrestat Study Group For Edit (Early Diabetes Intervention Trial). Frequency of median mononeuropathy in patients with mild diabetic neuropathy in the early diabetes intervention trial (EDIT). Muscle Nerve 1996; 19 (02) 140-146
    CrossrefPubMedSuche in Google Scholar
  • 10 Weiss A-PC, Sachar K, Gendreau M. Conservative management of carpal tunnel syndrome: a reexamination of steroid injection and splinting. J Hand Surg Am 1994; 19 (03) 410-415
    CrossrefPubMedSuche in Google Scholar
  • 11 Mondelli M, Padua L, Reale F, Signorini AM, Romano C. Outcome of surgical release among diabetics with carpal tunnel syndrome. Arch Phys Med Rehabil 2004; 85 (01) 7-13
    CrossrefPubMedSuche in Google Scholar
  • 12 Thomsen NOB, Rosén I, Dahlin LB. Neurophysiologic recovery after carpal tunnel release in diabetic patients. Clin Neurophysiol 2010; 121 (09) 1569-1573
    CrossrefPubMedSuche in Google Scholar
  • 13 Ozer K, Malay S, Toker S, Chung KC. Minimal clinically important difference of carpal tunnel release in diabetic and nondiabetic patients. Plast Reconstr Surg 2013; 131 (06) 1279-1285
    CrossrefPubMedSuche in Google Scholar
  • 14 Wroblewski AP, Mejia HA, Wright VJ. Application of platelet-rich plasma to enhance tissue repair. Oper Tech Orthop 2010; 20 (02) 98-105
    CrossrefSuche in Google Scholar
  • 15 Zheng C, Zhu Q, Liu X. et al. Effect of platelet-rich plasma (PRP) concentration on proliferation, neurotrophic function and migration of Schwann cells in vitro. J Tissue Eng Regen Med 2016; 10 (05) 428-436
    CrossrefPubMedSuche in Google Scholar
  • 16 Lichtenfels M, Colomé L, Sebben AD, Braga-Silva J. Effect of platelet rich plasma and platelet rich fibrin on sciatic nerve regeneration in a rat model. Microsurgery 2013; 33 (05) 383-390
    CrossrefPubMedSuche in Google Scholar
  • 17 Li H, Han Z, Liu D, Zhao P, Liang S, Xu K. Autologous platelet-rich plasma promotes neurogenic differentiation of human adipose-derived stem cells in vitro. Int J Neurosci 2013; 123 (03) 184-190
    CrossrefPubMedSuche in Google Scholar
  • 18 Thomsen NO, Cederlund R, Rosén I, Björk J, Dahlin LB. Clinical outcomes of surgical release among diabetic patients with carpal tunnel syndrome: prospective follow-up with matched controls. J Hand Surg Am 2009; 34 (07) 1177-1187
    CrossrefPubMedSuche in Google Scholar
  • 19 Mojaddidi MA, Ahmed MS, Ali R. et al. Molecular and pathological studies in the posterior interosseous nerve of diabetic and non-diabetic patients with carpal tunnel syndrome. Diabetologia 2014; 57 (08) 1711-1719
    CrossrefPubMedSuche in Google Scholar
  • 20 Ma J, Liu J, Yu H, Wang Q, Chen Y, Xiang L. Curcumin promotes nerve regeneration and functional recovery in rat model of nerve crush injury. Neurosci Lett 2013; 547: 26-31
    CrossrefPubMedSuche in Google Scholar
  • 21 Yasui G, Yamamoto Y, Shichinohe R. et al. Neuregulin-1 released by biodegradable gelatin hydrogels can accelerate facial nerve regeneration and functional recovery of traumatic facial nerve palsy. J Plast Reconstr Aesthet Surg 2016; 69 (03) 328-334
    CrossrefPubMedSuche in Google Scholar
  • 22 Küçük L, Günay H, Erbaş O, Küçük Ü, Atamaz F, Coşkunol E. Effects of platelet-rich plasma on nerve regeneration in a rat model. Acta Orthop Traumatol Turc 2014; 48 (04) 449-454
    CrossrefPubMedSuche in Google Scholar
  • 23 Yu W, Wang J, Yin J. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci 2011; 121 (04) 176-180
    CrossrefPubMedSuche in Google Scholar
  • 24 Giannessi E, Coli A, Stornelli MR. et al. An autologously generated platelet-rich plasma suturable membrane may enhance peripheral nerve regeneration after neurorraphy in an acute injury model of sciatic nerve neurotmesis. J Reconstr Microsurg 2014; 30 (09) 617-626
    Thieme ConnectPubMedSuche in Google Scholar
  • 25 Cho HH, Jang S, Lee SC. et al. Effect of neural-induced mesenchymal stem cells and platelet-rich plasma on facial nerve regeneration in an acute nerve injury model. Laryngoscope 2010; 120 (05) 907-913
    CrossrefPubMedSuche in Google Scholar
  • 26 Narai H, Nagano I, Ilieva H. et al. Prevention of spinal motor neuron death by insulin-like growth factor-1 associating with the signal transduction systems in SODG93A transgenic mice. J Neurosci Res 2005; 82 (04) 452-457
    CrossrefPubMedSuche in Google Scholar
  • 27 Park GY, Kwon DR. Platelet-rich plasma limits the nerve injury caused by 10% dextrose in the rabbit median nerve. Muscle Nerve 2014; 49 (01) 56-60
    CrossrefPubMedSuche in Google Scholar
  • 28 Zayni R, Thaunat M, Fayard JM. et al. Platelet-rich plasma as a treatment for chronic patellar tendinopathy: comparison of a single versus two consecutive injections. Muscles Ligaments Tendons J 2015; 5 (02) 92-98
    CrossrefPubMedSuche in Google Scholar
  • 29 Görmeli G, Görmeli CA, Ataoglu B, Çolak C, Aslantürk O, Ertem K. Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial. Knee Surg Sports Traumatol Arthrosc 2017; 25 (03) 958-965
    CrossrefPubMedSuche in Google Scholar
  • 30 Malahias MA, Johnson EO, Babis GC, Nikolaou VS. Single injection of platelet-rich plasma as a novel treatment of carpal tunnel syndrome. Neural Regen Res 2015; 10 (11) 1856-1859
    CrossrefPubMedSuche in Google Scholar
  • 31 Malahias MA, Nikolaou VS, Johnson EO, Kaseta MK, Kazas ST, Babis GC. Platelet-rich plasma ultrasound-guided injection in the treatment of carpal tunnel syndrome: a placebo-controlled clinical study. J Tissue Eng Regen Med 2018; 12 (03) e1480-e1488
    CrossrefPubMedSuche in Google Scholar
  • 32 Uzun H, Bitik O, Uzun Ö, Ersoy US, Aktaş E. Platelet-rich plasma versus corticosteroid injections for carpal tunnel syndrome. J Plast Surg Hand Surg 2017; 51 (05) 301-305
    CrossrefPubMedSuche in Google Scholar
  • 33 Raeissadat SA, Karimzadeh A, Hashemi M, Bagherzadeh L. Safety and efficacy of platelet-rich plasma in treatment of carpal tunnel syndrome; a randomized controlled trial. BMC Musculoskelet Disord 2018; 19 (01) 49
    CrossrefPubMedSuche in Google Scholar
  • 34 Trull-Ahuir C, Sala D, Chismol-Abad J, Vila-Caballer M, Lisón JF. Efficacy of platelet-rich plasma as an adjuvant to surgical carpal ligament release: a prospective, randomized controlled clinical trial. Sci Rep 2020; 10 (01) 2085
    CrossrefPubMedSuche in Google Scholar