Platelet-rich plasma for de Quervain’s tenosynovitis: A systematic review and meta-analysis

Table 1 Newcastle-Ottawa scale (prospective study)

No.	Ref.	Selection				Comparability	Outcome			Total
		1	2	3	4		1	2	3
1	Asaad et al[9], 2023	×		×	×		×	×	×	6
2	Deb et al[5], 2020	×	×	×	×	×	×	×	×	8
3	Giroti et al[12], 2021	×	×	×	×	××	×	×	×	9
4	Gulati and Ramesh[6], 2022	×	×	×	×	××	×	×	×	9
5	Johurul et al[29], 2019	×	×	×	×	××	×	×	×	9
6	Kumar et al[14], 2023	×	×	×	×	××	×	×	×	9
7	Ramesh et al[30], 2018	×		×	×		×	×	×	6
8	Sheikh et al[10], 2020	×	×	×	×	××	×	×	×	9

The maximum point for comparability was 2; Selection: (1) Representativeness; (2) Selection of non-exposed; (3) Ascertainment of exposure; and (4) Demonstration that outcome was not present at the beginning; Outcome: (1) Assessment of the outcome; (2) Follow-up long enough; and (3) Adequacy of follow-up.

Table 2 The Joanna Briggs Institute critical appraisal checklist for case report

No.	Major components	1	2
1	Were patient’s demographic characteristics clearly described?	Y	Y
2	Was the patient’s history clearly described and presented as a timeline?	Y	Y
3	Was the current clinical condition of the patient on presentation clearly described?	Y	Y
4	Were diagnostic tests or assessment methods and the results clearly described?	Y	Y
5	Was the intervention(s) or treatment procedure(s) clearly described?	Y	Y
6	Was the post-intervention clinical condition clearly described?	Y	Y
7	Were adverse events (harms) or unanticipated events identified and described?	Y	Y
8	Does the case report provide takeaway lessons?	Y	Y
	Overall appraisal	I	I

1: Chen et al[7], 2021, United States; 2: Peck and Ely[13], United States, 2013; I: Included, Y: Yes.

Table 3 The Joanna Briggs Institute critical appraisal checklist for case series

No.	Major components	1
1	Were there clear criteria for inclusion in the case series?	Y
2	Was the condition measured in a standard, reliable way for all participants included in the case series?	Y
3	Were valid methods used for identification of the condition for all participants included in the case series?	Y
4	Did the case series have consecutive inclusion of participants?	Y
5	Did the case series have complete inclusion of participants?	Y
6	Was there clear reporting of the demographics of the participants in the study?	Y
7	Was there clear reporting of clinical information of the participants?	Y
8	Were the outcomes or follow-up results of cases clearly reported?	Y
9	Was there clear reporting of the presenting site(s)/clinic(s) demographic information?	Y
10	Was statistical analysis appropriate?	NA
	Overall appraisal	I

1: Mahdi Al-ardi[8], Iraq, 2017; I: Included, NA: Not available; Y: Yes.

Table 4 Study characteristic

No.	Ref.	Study design	Sample (n)	Sample characteristic: age (year), gender (male, female)	Outcome measure	Result
1	Mahdi Al-ardi[8], 2017, Iraq	Case series	PRP: 30	Age: > 25	Pain reduction (VAS)	PRP injection reduced pain in 1, 3, and 6 months after treatment (VAS in baseline: 5.92; 1 months: 2.11; 3 months: 2.01; 6 months: 2.01; P < 0.001)
2	Asaad et al[9], 2023, Iraq	Prospective study	PRP: 12	Age: 43 (26-68); Gender: F	Pain reduction (VAS) and USG evaluation of tendon	PRP injection reduced pain significantly in 1 and 3 months after treatment (VAS in baseline: 8.66 ± 0.65; 1 months: 4.5 ± 1.97; 3 months: 1.91 ± 2.71; P < 0.001); decreased tendon sheath effusion significantly in 1 and 3 months after treatment (baseline: 2.07 ± 0.52; 1 months: 1.6 ± 0.75; 3 months: 0.73 ± 0.76; P < 0.001); decreased retinaculum thickness significantly in 1 and 3 months (baseline: 1.89 ± 0.5; 1 months: 1.3 ± 0.6; 3 months: 0.96 ± 0.56; P < 0.001); decreased peri-tendinous hyperemia significantly in 1 and 3 months (baseline: 58.3%; 1 months: 16.7%; 3 months: 0%; P < 0.001)
3	Chen et al[7], 2021, United States	Case report	PRP: 1	Age: 38; Gender: F	Pain reduction	The PRP injection reduced pain after 2 weeks, completely resolved it after 4 weeks, and there were no recurrent pain or weakness symptoms after 6 months
4	Deb et al[5], 2020, India	Prospective study	PRP: 67; Conservative: 64; CS: 69	PRP; Age: 53.96 ± 09.47; Gender: 38, 29; Conservative; Age: 51.85 ± 10.14; Gender: 43, 21; CS; Age: 57.49 ± 10.00; Gender: 33, 36	Pain reduction (VAS) and functional outcome (Mayo’s wrist score)	PRP injection reduced pain significantly in 1, 6, 12 months after treatment compared to conservative and CS therapy (VAS in 1 months: 4.91 ± 1.01 vs 6.37 ± 2.45 vs 5.13 ± 2.07; 6 months: 3.96 ± 1.94 vs 5.01 ± 0.26 vs 6.09 ± 1.41; 12 months: 2.11 ± 0.28 vs 7.61 ± 0.72 vs 4.93 ± 1.95; P < 0.001)
						PRP injection improved functional outcome significantly in 1, 6, 12 months after treatment compared to conservative and CS therapy (Mayo’s wrist score in 1 months: 73.61 ± 7.01 vs 39.71 ± 4.47 vs 63.45 ± 5.17, p: 0.045; 6 months: 83.47 ± 6.83 vs 51.43 ± 6.64 vs 70.94 ± 6.29, p: 0.003; 12 months: 87.24 ± 6.94 vs 64.78 ± 7.12 vs 72.01 ± 5.42, p: 0.001).
5	Giroti et al[12], 2021, India	Prospective study	PRP: 22 hand; CS: 28 hand	PRP; Age: 44.44 (27-60); Gender: 2, 20; CS; Age: 43.16 (31-59); Gender: 3, 24	Pain reduction (VAS) and disability reduction (DASH score)	PRP injection reduced pain in 6 months after treatment compared to CS therapy (VAS: 1.4 vs 2.1)
						PRP injection reduced disability compared to CS therapy (DASH score: 23.5 vs 39.7)
6	Gulati and Ramesh[6], 2022, India	Prospective study	PRP: 22; CS: 22	PRP; Age: 46.3 ± 9.7; Gender: 6, 16; CS; Age: 42.3 ± 5.8; Gender: 7, 15	Pain reduction (VAS) and disability reduction (DASH score)	PRP injection reduced pain significantly in 4, 12, and 24 weeks after treatment compared to CS therapy (VAS in 4 weeks: 5 vs 7; 12 weeks: 3.5 vs 5; 24 weeks: 1 vs 5; P < 0.001)
						PRP injection reduced disability significantly in 4, 12, and 24 weeks compared to CS therapy (DASH score in 4 weeks: 61.3 vs 93.1; 12 weeks: 40.9 vs 87.2; 24 weeks: 13.6 vs 72.7; P < 0.001)
7	Johurul et al[29], 2019, Bangladesh	Prospective study	PRP: 25; CS: 35	PRP; Age: 35 ± 2.1; Gender: 10, 15; CS; Age: 42 ± 7.3; Gender: 15, 20	Pain reduction (wrist pain)	PRP injection reduced pain significantly in 60 days after treatment compared to CS therapy (wrist pain: 1.1 ± 1.0 vs 2.7 ± 1.0, p: 0.0001)
8	Kumar et al[14], 2023, India	Prospective study	PRP: 30; CS: 30	PRP; Age: 35.83 ± 8.48; Gender: 8, 22; CS; Age: 37.80 ± 6.44; Gender: 10, 20	Pain reduction (VAS), disability reduction (DASH score), and functional outcome (Mayo’s wrist score)	PRP injection reduced pain insignificantly in 3, 6, 12 months after treatment compared to CS therapy (VAS in 3 months: 1.87 ± 1.78 vs 2.30 ± 2.32, p: 0.420; 6 months: 0.83 ± 0.99 vs 1.23 ± 1.61, p: 0.251; 12 months: 0.40 ± 0.62 vs 0.47 ± 0.78; p: 0.715)
						PRP injection reduced disability insignificantly in 3, 6, 12 months after treatment compared to CS therapy (DASH score in 3 months: 5.66 ± 6.56 vs 6.82 ± 8.70, p: 0.633; 6 months: 2.38 ± 3.87 vs 3.02 ± 5.13, p: 0.587; 12 months: 0.49 ± 0.85 vs 1.21 ± 2.83, p: 0.183)
						PRP injection improved functional outcome insignificantly in 3, 6, 12 months after treatment compared to CS therapy (Mayo’s wrist score in 3 months: 82.83 ± 8.68 vs 82.00 ± 9.34, p: 0.722; 6 months: 88.83 ± 6.91 vs 86.83 ± 7.13, p: 0.274; 12 months: 92.50 ± 4.10 vs 90.83 ± 5.88, p: 0.208)
9	Peck and Ely[13], 2013, United States	Case report	PRP: 1	Age: 74; Gender: F	Pain reduction (VAS)	PRP injection reduced pain in 3 and 6 months after treatment (VAS baseline: 38 of 100; 3 months: 10 of 100; 6 months: 14 of 100)
10	Ramesh et al[30], 2018, India	Prospective study	PRP: 141	Age: 41.24 (21-59); Gender: 77 , 64	Pain reduction (VAS) and functional outcome (Mayo’s wrist score)	PRP injection reduced pain significantly in 6 months after treatment (VAS: 9.42 vs 3.92, P < 0.001)
						PRP injection improved functional outcome significantly in 6 months after treatment (Mayo’s wrist score: 22.71 vs 71.46, P < 0.001)
11	Sheikh et al[10], 2020, Egypt	Prospective study	PRP: 20 hand; CS: 20 hand	PRP; Age: 41.45 ± 11.54; Gender: 15, 2; CS; Age: 41.30 ± 8.06; Gender: 16, 2	Pain reduction (VAS), disability reduction (qDASH score), functional outcome (JHFT), and USG evaluation of tendon	PRP injection reduced pain significantly in 6 months after treatment compared to CS therapy (VAS: 2.13 ± 2.75 vs 1.94 ± 3.04, p: 0.034)
						PRP injection reduced disability significantly in 6 months after treatment compared to CS therapy (qDASH score: 10.90 ± 10.86 vs 9.38 ± 13.52, p: 0.729)
						PRP injection improved functional outcome significantly in 6 months after treatment compared to CS therapy (JHFT: 49.56 ± 5.98 vs 50.39 ± 7.63, p: 0.735)
						PRP injection decreased tendon thickness insignificantly in 6 months after treatment compared to CS therapy (LS: 2.35 ± 0.77 vs 1.99 ± 0.53, p: 0.133; TS: 2.54 ± 0.67 vs 2.42 ± 0.57, p: 0.571); decreased tendon and sheath thickness insignificantly in 6 months after treatment compared to CS therapy (LS: 3.23 ± 0.92 vs 2.91 ± 0.96, p: 0.335; TS: 3.53 ± 0.87 vs 3.18 ± 0.63, p: 0.183); decreased extensor retinaculum thickness significantly in 6 months after treatment compared to CS therapy (0.98 ± 0.35 vs 0.59 ± 0.25, P < 0.001)
12	Shoma et al[11], 2023, Bangladesh	RCT	PRP: 33; Conservative: 30; CS: 31	PRP; Age: 45.6 ± 10.4; Gender: 12, 21; Conservative; Age: 42.4 ± 6.3; Gender: 7, 23; CS; Age: 46.9 ± 11.3; Gender: 9, 22	Pain reduction (VAS) and functional outcome (Mayo’s wrist score)	PRP injection reduced pain significantly in 3 and 6 months after therapy compared to conservative and CS therapy (VAS: 3.5 ± 0.7 vs 4.4 ± 0.7 vs 3.9 ± 0.5, P < 0.001)
						PRP injection improved functional outcome significantly in 3 and 6 months after therapy compared to conservative and CS therapy (Mayo’s wrist score: 87.9 ± 3.7 vs 65.2 ± 7.2 vs 73.7 ± 4.8, P < 0.001)

CS: Corticosteroid; DASH: Disabilities of the arm, shoulder, and hand; DQT: De quervain’s tenosynovitis; F: Female; JHFT: Jebsen hand function test; LS: Longitudinal section; n: Number; p: Probability; PRP: Platelet-rich plasma; ROM: Range of motion; TS: Transeversal section; qDASH: Quick disabilities of the arm, shoulder, and hand; USG: Ultrasonography; VAS: Visual analogue scale.