Literature DB >> 23100191

Endoscopic carpal tunnel release is preferred over mini-open despite similar outcome: a randomized trial.

Ho Jung Kang1, Il Hyun Koh, Tae Jin Lee, Yun Rak Choi.   

Abstract

BACKGROUND: The decision to perform endoscopic versus the mini-open carpal tunnel release technique is most likely left to surgeons rather than patients with idiopathic carpal tunnel syndrome. QUESTIONS/PURPOSES: We hypothesized that (1) at 3 months after surgery, the subjective outcomes of endoscopic release, performed on one hand, and mini-incision release, performed on the other, would not differ in patients with bilateral carpal tunnel syndrome; however, (2) each patient would likely prefer one technique over the other for specific reasons.
METHODS: Fifty-two patients with bilateral carpal tunnel syndrome had one hand randomized to undergo endoscopic release and the other to undergo mini-incision release. Each patient was assessed with the Boston Carpal Tunnel Questionnaire (BCTQ) and DASH preoperatively and at each followup. Three months after surgery, the patients commented on which technique they preferred and completed a questionnaire regarding the reasons for not preferring the other technique.
RESULTS: The mean BCTQ symptom/function score and DASH improved similarly in the endoscopic release group and the mini-incision release group. Thirty-four patients preferred endoscopic release and 13 preferred the mini-incision technique. Scar or pillar pain was the most commonly cited factor in not preferring either technique followed by postoperative pain for the open technique and transient worsening of symptoms for the endoscopic technique.
CONCLUSIONS: Despite similar improvements in BCTQ and DASH scores after endoscopic and open techniques at 3 months postoperatively, the majority of our patients preferred the endoscopic technique. The most concerning reason for not preferring the other technique was scar or pillar pain.

Entities:  

Mesh:

Year:  2012        PMID: 23100191      PMCID: PMC3613542          DOI: 10.1007/s11999-012-2666-z

Source DB:  PubMed          Journal:  Clin Orthop Relat Res        ISSN: 0009-921X            Impact factor:   4.176


  29 in total

1.  Prospective randomized trial comparing absorbable and non-absorbable sutures in open carpal tunnel release.

Authors:  N Kharwadkar; S Naique; P J A Molitor
Journal:  J Hand Surg Br       Date:  2005-02

2.  Endoscopic carpal tunnel release. The Agee technique.

Authors:  D S Ruch; G G Poehling
Journal:  Hand Clin       Date:  1996-05       Impact factor: 1.907

3.  Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG)

Authors:  P L Hudak; P C Amadio; C Bombardier
Journal:  Am J Ind Med       Date:  1996-06       Impact factor: 2.214

4.  Outcomes of endoscopic surgery compared with open surgery for carpal tunnel syndrome among employed patients: randomised controlled trial.

Authors:  Isam Atroshi; Gert-Uno Larsson; Ewald Ornstein; Manfred Hofer; Ragnar Johnsson; Jonas Ranstam
Journal:  BMJ       Date:  2006-06-15

5.  Mini-open blind procedure versus limited open technique for carpal tunnel release: a 30-month follow-up study.

Authors:  Paolo Cellocco; Constantino Rossi; Francesco Bizzarri; Luigi Patrizio; Giuseppe Costanzo
Journal:  J Hand Surg Am       Date:  2005-05       Impact factor: 2.230

6.  Intra-individual comparison between open and 2-portal endoscopic release in clinically matched bilateral carpal syndrome.

Authors:  M Rab; M Grünbeck; H Beck; W Haslik; K F Schrögendorfer; H-P Schiefer; M Mittlböck; M Frey
Journal:  J Plast Reconstr Aesthet Surg       Date:  2006-02-21       Impact factor: 2.740

7.  Endoscopic versus open carpal tunnel release: a cost-effectiveness analysis.

Authors:  K C Chung; M R Walters; M L Greenfield; M E Chernew
Journal:  Plast Reconstr Surg       Date:  1998-09       Impact factor: 4.730

Review 8.  Pillar pain as a postoperative complication of carpal tunnel release: a review of the literature.

Authors:  K S Ludlow; J L Merla; J A Cox; L N Hurst
Journal:  J Hand Ther       Date:  1997 Oct-Dec       Impact factor: 1.950

9.  A randomized controlled trial of surgery vs steroid injection for carpal tunnel syndrome.

Authors:  A C F Hui; S Wong; C H Leung; P Tong; V Mok; D Poon; C W Li-Tsang; L K Wong; R Boet
Journal:  Neurology       Date:  2005-06-28       Impact factor: 9.910

10.  Incorporating patient preferences into orthopaedic practice: should the orthopaedic encounter change?

Authors:  Dianne Bryant; Elzbieta Bednarski; Amiram Gafni
Journal:  Injury       Date:  2006-02-14       Impact factor: 2.586

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  25 in total

1.  Similar effectiveness of the open versus endoscopic technique for carpal tunnel syndrome: a prospective randomized trial.

Authors:  Seyit Ali Gümüştaş; Burcu Ekmekçi; Haci Bayram Tosun; Mehmet Müfit Orak; Halil İbrahim Bekler
Journal:  Eur J Orthop Surg Traumatol       Date:  2015-08-30

2.  Ultrasound Evaluation for Incomplete Carpal Tunnel Release.

Authors:  Jacob E Tulipan; Amir Reza Kachooei; Jonathan Shearin; Yvonne Braun; Mark L Wang; Michael Rivlin
Journal:  Hand (N Y)       Date:  2019-03-12

3.  Open versus endoscopic carpal tunnel release: a meta-analysis of randomized controlled trials.

Authors:  Eli T Sayegh; Robert J Strauch
Journal:  Clin Orthop Relat Res       Date:  2014-08-19       Impact factor: 4.176

4.  A Prospective, Randomized Trial Comparing Open and Endoscopic Carpal Tunnel Release Within the Same Patient.

Authors:  Brett M Michelotti; Kavita T Vakharia; Diane Romanowsky; Randy M Hauck
Journal:  Hand (N Y)       Date:  2018-11-21

5.  Cost Implications of Varying the Surgical Technique, Surgical Setting, and Anesthesia Type for Carpal Tunnel Release Surgery.

Authors:  Nikolas H Kazmers; Angela P Presson; Yizhe Xu; Abby Howenstein; Andrew R Tyser
Journal:  J Hand Surg Am       Date:  2018-05-18       Impact factor: 2.230

6.  Improved Surgical Outcomes With Endoscopic Carpal Tunnel Release in Patients With Severe Median Neuropathy.

Authors:  Nicholas A Calotta; Joseph Lopez; E Gene Deune
Journal:  Hand (N Y)       Date:  2016-07-28

7.  A Systematic Review of Randomised Control Trials Evaluating the Efficacy and Safety of Open and Endoscopic Carpal Tunnel Release.

Authors:  Eilidh MacDonald; Paul M Rea
Journal:  Adv Exp Med Biol       Date:  2022       Impact factor: 2.622

8.  Economic benefit of carpal tunnel release in the Medicare patient population.

Authors:  Zachary S Hubbard; Tsun Yee Law; Samuel Rosas; Sarah C Jernigan; Harvey Chim
Journal:  Neurosurg Focus       Date:  2018-05       Impact factor: 4.047

9.  Initial Outcomes of a Novel High-Visibility Endoscopic Carpal Tunnel Release Technique.

Authors:  Bo Liu; Feiran Wu
Journal:  J Wrist Surg       Date:  2020-09-02

10.  Patient Willingness to Pay for Faster Return to Work or Smaller Incisions.

Authors:  Aaron Alokozai; Sarah E Lindsay; Sara L Eppler; Paige M Fox; Amy L Ladd; Robin N Kamal
Journal:  Hand (N Y)       Date:  2019-12-02
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