Comparison of Knifelight Surgery versus Conventional Open Surgery in the Treatment of Carpal Tunnel Syndrome

Abstract

BackgroundA variety of surgical treatment methods for carpal tunnel syndrome are introduced recently, including open surgery, endoscopic and the Knifelight. It is hypothesized that Knifelight method could decrease scar tenderness and time before return to daily activities for patients and is accompanied with less disturbance to fine sensory nerves.ObjectivesTo compare the Knifelight instrument and open carpal tunnel release with respect to scar length, operation duration, recovery time needed before return to work and amount of pain three weeks after surgery in patients with neurophysiologically confirmed carpal tunnel syndrome.Patients and MethodsFifty nine patients with indication for carpal tunnel release randomly assigned into two groups: open (n=30) or Knifelight (n=29). The patients compared regarding scar length, operation duration, time to return to daily activities and amount of pain at three weeks after operation based on Visual Analog Scale.ResultsThere was no significant differences regarding age and sex in the two groups. The scar length, operation duration and time before return to daily activities were significantly lower in the Knifelight group. Although the mean visual analogue scale of Knifelight group found to be lower than the other, it was not statistically significant.ConclusionsThe Knifelight technique is accompanied with advantages over the open surgery regarding operation time, scar length and time to return to daily activities. The pain relieve based on Visual Analog Scale was not statistically different from conventional open surgery.

The comparison of limited-incision versus standard-incision in treatment of carpal tunnel syndrome

“…On account of the heterogeneity between the groups of interval to return to activities is small ( I 2 = 49%), a fixed effect model is used. Patients who treated with limited carpal tunnel release returned to activities earlier than patients who treated with standard release (MD,−8.80 [−9.21 to −8.39]; P < .01) [18,21,22,24,26,29] (Fig. 4).…”

Factors affecting symptoms and functionality of patients with carpal tunnel syndrome: a retrospective study

“…Elfar et al stated that conservative therapy generally offers only temporary relief of symptoms 7 ) . On the other hand, some studies have reported that conservative treatment is ineffective, and that almost one-third of patients diagnosed with CTS will require surgery 24 , 25 , 26 ) . Two-thirds of patients who underwent carpal tunnel release reported being completely or very much satisfied with the outcome in follow-up examination 6, 18, and 30 months after surgery 25 ) .…”

“…On the other hand, some studies have reported that conservative treatment is ineffective, and that almost one-third of patients diagnosed with CTS will require surgery 24 , 25 , 26 ) . Two-thirds of patients who underwent carpal tunnel release reported being completely or very much satisfied with the outcome in follow-up examination 6, 18, and 30 months after surgery 25 ) . A number of non-surgical interventions reported in the literature have been useful for the treatment CTS in the short-term, but there is sparse in the evidence of their long-term effectiveness 3 ) .…”

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

“…Furthermore, endoscopic surgery is advantageous in terms of the time period of pain and before going back to work [8][9][10][11]. However, results were reported regarding the complication rates of these methods [10][11][12][13][14][15][16][17][18][19] (Table 1).…”