Use of Ultrasound-Guided Platelet-Rich Plasma in the Treatment of Carpometacarpal Osteoarthritis.

Introduction: Osteoarthritis (OA) is the most common form of arthritis and can severely affect function and quality of life. Platelet-rich plasma (PRP) is derived from a patient's own blood and has potential as an adjunct to treat OA. However, research has been limited for small joints such as the carpometacarpal (CMC) joint. Clinical Findings: A 65-year-old Caucasian male complained of bilateral wrist and neck pain after a motor vehicle accident. His initial exam noted swelling, tenderness and pain with movement at the bilateral thumb CMC joints and anatomic snuffboxes. However, there was no strength, range of motion or tactile deficits during examination. Outcomes: He was found to have moderate to severe OA bilaterally in his left and right CMC joints seen on computed tomography and magnetic resonance imaging. The patient was initially treated with ultrasound (US)-guided steroid injections but did not experience significant improvement. After careful discussion, the patient chose to undergo US-guided injection of PRP into both joints. Follow-up at six weeks after PRP injection revealed that there was functional improvement in both joints as well as objective improvement via the Mayo Wrist Score survey. Conclusion: US-guided PRP injection can be used as an alternative modality to treat OA of the CMC joints when approaches such as conservative therapy and steroid injections have failed. PRP has not been as well studied as other interventions such as corticosteroid injections, but it may offer less long-term adverse effects and be considered a potential alternative or adjuvant to current treatment modalities.