1000 Section - Ultrasound-Guided High Molecular Weight Hyaluronic Acid Injection for Carpal Tunnel Syndrome: A Randomized Controlled Trial

Objectives : To address these gaps, we conducted a randomized controlled trial comparing ultrasound-guided HA injections with standard care (lidocaine/saline + splinting) in mild-to-moderate CTS. Our study uniquely integrates patient-reported outcomes (BCTQ, VAS) with objective electrophysiological (DSL, DML) and sonographic (CSA) measures to holistically evaluate HA’s therapeutic potential. By employing a standardized ultrasound-guided in-plane ulnar approach, we aimed to isolate HA’s efficacy while minimizing technical variability. This design not only clarifies HA’s standalone benefits but also provides insights into its mechanism of action in CTS, bridging the divide between preclinical promise and clinical practice.

Design: This study employed a parallel-group randomized placebo-controlled trial design, adhering to the consolidated standards of reporting trials 2022 (CONSORT) guidelines. Conducted from June 2019 to April 2021, the trial involved two outpatient physical medicine and rehabilitation clinics with high patient volumes . The study followed a 1:1 randomization scheme, with participants assigned to one of two parallel arms

Results: This clinical trial involved 60 patients with mild to moderate CTS who were randomly assigned to two treatment groups. The study process, including patient enrollment and group assignment, is depicted in the CONSORT flow diagram . Baseline demographic characteristics and outcome measures, along with patients’ pre-intervention values, are presented in Table 1. No statistically significant differences were observed between the groups for these parameters, except that the HA group exhibited a significantly higher age (P = 0.041).

Conclusion: The study indicates that US-guided HA injection into the carpal tunnel using the ulnar in-plane approach is linked to improvements in pain, function, and electrodiagnostic and ultrasound findings in patients with mild to moderate CTS. Based on the research findings, this treatment method holds promise for enhancing the management of CTS.