Lipografting Versus Steroid Injections for Treatment of Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy affecting up to 13% of
Americans; CTS is caused by compression of the median nerve in the carpal tunnel leading to
nerve ischemia and symptoms of numbness, pain, and tingling. Treatment options depend on the
severity of symptoms and range from noninvasive options (most commonly, steroid injections)
to definitive surgical release of the compressed median nerve. Both non-invasive techniques
and surgical intervention have their shortcomings; thus a novel approach for CTS treatment
may be indicated.

Lipografting is an established, validated, and widely used technique of plastic surgeons that
injects autologous fat to correct contour deformities. From observing these reconstructions,
plastic surgeons have witnessed the regenerative properties of fat transfer, specifically
delaying the affects of chronic radio-dermatitis. These clinical manifestations have fostered
numerous studies defining fat as a rich source of pluripotent stem cells with the potential
for reducing scar formation, bringing neo-angiogenesis, and providing a barrier against scar
adhesions This study applies the regenerative properties of autologous fat transfer to treat
mild to moderate carpal tunnel syndrome in comparison to the current standard of care,
corticosteroid treatment. Ideally, the fat transfer would prevent scar formation and aid in
nerve excursion along the canal, while the neoangiogenic and regenerative growth factors
could stimulate nerve regeneration.

Inclusion Criteria:

- primary mild to moderate carpal tunnel syndrome (CTS)

- report symptoms longer than 6 months

- night pain

- weakness

- sensory deficits

- fluent English-speaking adult (>18)

Exclusion Criteria:

- <18 years old

- Non-english speaking

- injection in past 6 months

- previous hand surgery

- previous hand trauma (fracture or dislocation)