Platelet-rich plasma for thumb carpometacarpal joint osteoarthritis in a professional pianist: case-based review

Rheumatol Int. 2019 Dec;39(12):2167-2175. doi: 10.1007/s00296-019-04454-x. Epub 2019 Oct 14.

Abstract

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.

Keywords: Autologous therapy; Growth factors; Hand injuries; Osteoarthritis; Thumb; Trapeziometacarpal joint.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Activities of Daily Living
  • Carpometacarpal Joints / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis / physiopathology
  • Osteoarthritis / therapy*
  • Patient Satisfaction
  • Pinch Strength / physiology*
  • Platelet-Rich Plasma*
  • Treatment Outcome