Efficacy of Ultrasound-Guided Deep Perineural Platelet Rich Plasma versus Corticosteroid Injection in Patients with Ulnar Neuropathy at Elbow, A Comparative Randomized Trial

Background: Ulnar neuropathy at elbow (UNE) is the 2nd most common compressive neuropathy in the upper extremities, following carpal tunnel syndrome. It occurs when compression and traction are applied to the ulnar nerve (UN) at the elbow.
Aim: This study aimed to assess and compare the therapeutic effects of ultrasound-guided deep perineural platelet rich plasma (PRP) against injection of corticosteroid (CS) among individuals with ulnar neuropathy at elbow (UNE).
Subjects and methods: This randomised prospective study was performed on sixty adult participants with mild to moderate UNE who were categorized into 2 groups. Group I received single US-guided perineural PRP injection, and group II underwent single US-guided perineural corticosteroid injection.
Results: In comparison with baseline, almost all primary outcome measures in groups II and I significantly improved after the first- and third-months post-injection, respectively. Almost all participants in the two groups under study had successful results with ultrasound guided perineural injection of either PRP or corticosteroid with no adverse effects. Linear regression of tested variables showed that ulnar nerve cross-sectional area (CSA) and nerve conduction velocity (NCV) slowing across elbow were among the potential predictors for favorable outcomes after corticosteroid and /or PRP injection.
Conclusions: Ultrasound guideddeepperineural PRP and corticosteroid injection are a safe and effective tool for mild to moderate cases of UNE without any difference in outcome measures. Milder cases of UNE were identified to predict better recovery with regard to nerve healing after PRP more than corticosteroid injection as a long-term therapy.