Comparative study between corticosteroids and platelet-rich plasma in the treatment of de Quervain’s tenosynovitis

Background: De Quervain tenosynovitis is named after the Swiss surgeon, Fritz de Quervain, who first described it in 1895. It is a condition that involves tendon entrapment affecting the first dorsal compartment of the wrist. Pain is exacerbated by thumb movement and radial and ulnar deviation of the wrist. De Quervain tendinopathy can be self-limited and may resolve without intervention. For those individuals with persistent symptoms splinting, systemic inflammatories, and corticosteroid injections are frequently used as non-surgical treatment options. Corticosteroids have both anti-inflammatory and immunosuppressive effects and have been used in the treatment of DQST. With the widespread increase in research in the field of regenerative orthopedics, PRP has become a natural, biological enhancer. Platelet-rich plasma (PRP) is safe and reduces symptoms in different tendon pathologies, such as De Quervain's disease. It has a high concentration of platelets above baseline in comparison to whole blood count to accelerate tissue healing, modulate inflammation, and provide symptomatic relief.

Aim: To evaluate the effectiveness of PRP injection in comparison to corticosteroid injection in the treatment of DQST.

Methods: Patients underwent randomization into groups: corticosteroids and PRP. We followed both groups at 4, 12, and 24 weeks for improvement in wrist pain, disability, and finger motion. The resolution of symptoms and improvements in the Visual Analog Scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores were assessed to evaluate treatment success.

1) Forty-four patients with suspected DQST were divided into two groups, i.e., PRP group I and corticosteroid group II in a 1:1 by lottery method.

2) Pain measured by VAS score has shown a reduction in pain in the PRP group-I with every follow-up.

However, a similar pattern was not shown in the corticosteroid group II. We found in our study that a lower DASH score was found in 14(63.64%) patients of PRP group I compared to 8(36.36%) patients of corticosteroid group II. After PRP injection, pain, disability, and finger motion improve steadily and eventually get better.

Conclusions: Based on results found in the present study, for De Quervain's Tenosynovitis (DQST) condition, PRP injections were superior to corticosteroid injections in terms of pain management, finger motion, and reduced disability.