PRP vs Corticosteroid for Thumb CMC Osteoarthritis: Prospective RCT
Malahias MA · Cartilage (2021)
DOI: 10.1177/1947603518819761This landmark RCT was the first to compare PRP against corticosteroid injection for thumb base (trapeziometacarpal) osteoarthritis. Thirty-three patients with Eaton-Littler grade I-III disease received either two ultrasound-guided PRP injections or two corticosteroid injections two weeks apart. PRP demonstrated significant improvements in both pain (VAS) and function (Quick-DASH) at 3 and 12 months, with sustained benefit where corticosteroid effects faded over time. The study opened a new application area for PRP in small joint osteoarthritis.
Clinical Relevance
Provides Level 1 evidence supporting PRP for thumb CMC OA, a common and functionally debilitating condition affecting primarily postmenopausal women. Given the limited surgical options for small joint OA and the risks of repeated corticosteroid injections (cartilage degradation), PRP represents a promising alternative.
Key Takeaways
- First RCT for PRP in thumb CMC osteoarthritis
- PRP significantly superior to corticosteroid at 3 and 12 months
- VAS improved from 75 to 40, qDASH from 50 to 33 in PRP group
- Two ultrasound-guided injections at 2-week intervals
- Small sample (n=33) but randomized design
- Corticosteroid showed typical pattern of initial relief followed by fade
Key Findings
PRP significantly reduced VAS pain (75 to 40) and improved qDASH (50 to 33) at both 3 and 12 months. PRP was superior to corticosteroid at all timepoints. First RCT for PRP in thumb CMC OA.
Clinical Context
Study Design
Prospective Randomized Controlled Clinical Trial
Condition
Thumb Carpometacarpal (Trapeziometacarpal) Osteoarthritis
Sample Size
33 patients
Follow-up
12 months
Control Group
Corticosteroid (methylprednisolone + lidocaine)
Primary Outcome
VAS, Quick-DASH
PRP Protocol & Intervention
Injection Frequency
2 injection(s)
Injection Interval
2 weeks
Guidance Method
Ultrasound-guided