Orthopedic PRP
    Orthopedic PRP
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    Hand (Thumb CMC + STT Joint)
    Level 4 Evidence
    Hand OA (Thumb CMC + STT)
    No Significant Benefit

    PRP for Hand and Thumb OA: Effects on Basal Joint and STT Joint

    Rydberg M · PLOS One (2022)

    DOI: 10.1371/journal.pone.0264203

    This retrospective case series from a specialized hand surgery unit evaluated PRP injections for both thumb basal joint and scaphoidtrapeziotrapezoidal (STT) joint OA in 29 patients. Using the Arthrex ACP double-syringe system, patients received two radiologically guided PRP injections 3-4 weeks apart. Despite controlling for confounders using generalized estimating equations (GEE), PRP showed no significant effect on any objective outcome measure.

    Clinical Relevance

    The disconnect between subjective improvement (57%) and objective measures (no change) suggests PRP may have a strong placebo component in hand OA. Clinicians should be cautious about interpreting patient satisfaction alone as evidence of efficacy.

    Key Takeaways

    • No objective improvement in pain, function, or strength at 3 months
    • 16/28 patients reported subjective improvement despite no objective change (placebo effect)
    • Used Arthrex ACP (LP-PRP) system, well-characterized protocol
    • Small injection volumes (0.5-2 mL) appropriate for small joints
    • GEE analysis controlled for confounders (age, sex, occupation, pain level)
    • Only 3-month follow-up (may be too short)
    • STT joint OA also included (rare data for this joint)

    Key Findings

    29 patients (21 thumb CMC, 8 STT). GEE analysis showed PRP had NO significant effect on pain, PRWHE, grip strength, or key pinch at 3 months. 16/28 patients subjectively reported improvement despite no objective improvement. Short-term PRP effect for hand OA is doubtful.

    Clinical Context

    Study Design

    Retrospective Case Series

    Condition

    Thumb Basal Joint OA and Scaphoidtrapeziotrapezoidal (STT) Joint OA

    Sample Size

    29 patients

    Follow-up

    3 months

    Control Group

    None (before-after comparison)

    Primary Outcome

    NRS Pain, PRWHE, Grip/Pinch Strength

    PRP Protocol & Intervention

    Preparation System

    Arthrex ACP Double-Syringe

    Leukocyte Status

    LP-PRP (ACP system)

    Spin Protocol

    1500 rpm for 5 minutes

    Injection Frequency

    2 injection(s)

    Injection Interval

    3-4 weeks

    Guidance Method

    Radiologically guided

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