Platelet-rich plasma for thumb carpometacarpal joint osteoarthritis in a professional pianist: case-based review
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Thumb carpometacarpal osteoarthritis (TCMC-OA) is a progressively disabling, debilitating condition presenting with thumb base pain and hand functional impairment. Platelet-rich plasma has been used widely for the management of musculoskeletal pathologies, OA being among them. To our knowledge, only a few cases have been previously reported on this topic until now. A 59-year-old male professional pianist presented with chronic, mild onset of right thumb base pain involving a progressive lack of pinch strength in his right hand, and severe difficulties with playing. Three PRP injections were administered to the TCMC joint on a 1-week interval regime. Clinical outcomes were assessed by using the visual analog scale (VAS) for pain, grip and pinch strength, and the Quick-DASH Questionnaire. Functional outcome was excellent according to patient’s capability with daily living activities and specific playing demands. At 12 months follow-up, no recurrences or complications were identified, with the musician returning to his previous level of performance 2 weeks before the end of this period. Patient self-reported satisfaction was high and he reported to return to his routine piano activity with no limitations. This case-based review study documents the clinical efficacy of PRP treatment from both functional and perceived-pain perspectives in a professional pianist. Presenting this case, our aim is to draw attention of healthcare providers dealing with TCMC-OA to PRP as a safe, beneficial therapy for this condition which needs further assessment in randomized controlled trials.
KeywordsGrowth factors Autologous therapy Hand injuries Osteoarthritis Trapeziometacarpal joint Thumb
The authors would like to gratefully acknowledge the contribution of Raquel Navarro-Ger for her assistance and unconditional encouragement.
IM-P conceived, designed and coordinated the study, devised search strategies, drafted the inclusion selection form, wrote and drafted the manuscript; PM-G provided reported data, and analyzed and interpreted the data; SS-DD performed data acquisition, analyzed and interpreted the data, and helped draft the manuscript; MR-E provided critical feedback and helped shape the manuscript; RC-T participated in study design, search strategies, and format advice, and helped revise the manuscript. All authors approved the revised version manuscript and agreed to be accountable for all aspects of the current study.
The authors declared that this study has received no financial support.
Compliance with ethical standards
Conflict of interest
Ivan Medina-Porqueres, Pablo Martin-Garcia, Sofia Sanz-De Diego, Marcelo Reyes-Eldblom, and Raquel Cantero-Tellez declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All authors fulfilled the ICMJE authorship criteria.
Written informed consent was obtained from the patient prior to submission of this article for consideration as a case-based review.
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