Effectiveness of adjuvant leukocyte-poor platelet-rich plasma in carpal tunnel release: a randomized controlled trial

This study assessed the effectiveness of adding leukocyte-poor platelet-rich plasma (PRP) during carpal tunnel release surgery for patients with moderate to severe carpal tunnel syndrome. In a randomized controlled trial, 70 patients were assigned to either standard carpal tunnel release (control group) or release with leukocyte-poor PRP applied to the median nerve (PRP group). Primary outcomes were measured using the Boston Carpal Tunnel Questionnaire at 3 months, and secondary outcomes included pain, strength, sensation and electrodiagnostic examinations at multiple time points. Both groups showed similar improvements in pain, function, grip and pinch strength and electrophysiological recordings. However, the PRP group had better resolution of numbness at 3 months. These findings suggest that local PRP augmentation does not provide significant additional benefits beyond those of carpal tunnel release alone, apart from some improvement in patients' perception of numbness.Level of evidence: II.