# Efficacy of Intralesional Platelet-Rich Plasma in Patients With de Quervain’s Tenosynovitis

## TL;DR

Intralesional platelet-rich plasma injections effectively relieve pain in most patients with de Quervain’s tenosynovitis, but are less effective in those with diabetes.

## Contribution

Demonstrates the efficacy of PRP injections for de Quervain’s tenosynovitis and identifies diabetes as a significant factor affecting treatment outcomes.

## Key findings

- PRP injections significantly reduced pain scores in 85.1% of patients with de Quervain’s tenosynovitis.
- Patients with diabetes had higher post-treatment pain scores and were less likely to respond to PRP treatment.
- Other factors like age, gender, and occupation did not significantly affect treatment outcomes.

## Abstract

Background

De Quervain’s tenosynovitis is a disorder of the tendons of the first dorsal compartment of the wrist that causes pain and functional disability and may be refractory to conservative treatments. This research was done to determine the efficacy of intralesional platelet-rich plasma (PRP) in patients with de Quervain’s tenosynovitis.

Methodology

This quasi-experimental study was performed at the Department of Orthopedic Surgery, King Edward Medical University/Mayo Hospital, Lahore, Pakistan, from September 2021 to October 2022. Patients of either gender, aged between 18 and 60 years, and presenting with de Quervain’s tenosynovitis were analyzed. The patient received a PRP injection plus an oral nonsteroid anti-inflammatory drug (NSAID; naproxen 500 mg twice daily). The patient was evaluated three weeks after treatment for efficacy. Efficacy was labeled as a visual analog scale (VAS) pain score of < 3 after three weeks of intralesional PRP injection.

Results

In a total of 67 patients, 42 (62.7%) were male. The mean age was 44.26±6.48 years. The mean pre-treatment VAS score was 7.24±1.36. The mean post-treatment VAS score after 3 weeks of intralesional PRP injection was 2.14±0.63 (p<0.001). Patients with diabetes had higher post-treatment VAS scores (2.33±0.75) compared to those without (1.99±0.48), indicating a significant difference (p=0.025). Other characteristics, such as hypertension (p=0.334), family history of musculoskeletal disorders (p=0.704), duration of symptoms (0.346), hand dominance (p=0.516), and occupation (p=0.649), did not show significant differences in post-treatment VAS scores. Efficacy was achieved in 85.1% (n=57) of patients. Non-efficacy was significantly associated with diabetes mellitus (80% of non-responders vs. 36.8% of responders, p=0.011). Other factors, such as gender (p=0.289), age (p=0.279), BMI (p=0.258), residence (p=0.933), smoking history (p=0.358), hypertension (p=0.808), family history of musculoskeletal disorders (p=0.553), symptom duration (p=0.983), hand dominance (p=0.096), or occupation (p=0.935), were not significantly associated with treatment efficacy.

Conclusion

Intralesional PRP injections provide effective pain relief in the majority of patients with de Quervain’s tenosynovitis. While the treatment appears effective across most patient subgroups, diabetes mellitus significantly reduces the likelihood of success, indicating the need for personalized treatment approaches in such cases.