Extended Follow-up of a Randomized Clinical Trial of Open vs Endoscopic Release Surgery for Carpal Tunnel Syndrome

Abstract

efforts and pay-for-performance initiatives. Considering the burden of revisits to patients and hospitals following ambulatory operations, our study highlights the importance of expanding health policy and clinical interventions to include ambulatory surgery and complications assessed in the ED.Future work should determine associated risk factors and which complications are potentially preventable.follow-up (mean [SD] change from baseline, 1.8 [0.8]; from 1 year, −0.003 [0.6]). Adjusted mean between-group difference in change from baseline was −0.03 (95% CI, −0.25 to 0.19; P = .79) and from 1 year was −0.03 (95% CI, −0.23 to 0.17; P = .76). No between-group differences were found in the secondary outcomes ( Table 2).Discussion | To our knowledge, this is the first randomized trial to evaluate long-term outcomes of CTS surgery. After a mean follow-up of 12.8 years after CTS surgery, there were no significant differences between open and endoscopic carpal tunnel release. The large symptom and functional improvements and high level of patient satisfaction achieved with surgery were durable and few patients had undergone further surgery.Study limitations include a single institution in Sweden and unknown generalizability. Our long-term follow-up was limited to patient-reported outcomes, which are central in CTS and were consistent across several measures with established reliability and validity. The results should help clinicians and patients in making treatment decisions.

Open versus endoscopic carpal tunnel release: A systematic review and meta-analysis of randomized controlled trials

“…5) (24,32,33), and BCTQ-F score at 1 year post-surgery (MD, 0.17; 95% CI, -0.02 to 0.36; P = 0.08; n = 592; random-effects model, with a heterogeneity of I 2 = 91%; P < 0.00001; Fig. 6) (24,32,33) between the ECTR and OCTR groups. Similarly, there were no differences in digital sensation, including the Semmes-Weinstein monofilament test score at 3 months post-surgery (MD, 0.06; 95% CI, -0.09 to 0.21; P = 0.43; n = 297; fixed-effects model, with a heterogeneity of I 2 = 0%; P = 0.65; Fig.…”

“…4) (9,31), BCTQ-S score at 1 year post-surgery (MD, 0.15; 95% CI, -0.04 to 0.35; P = 0.13; n = 592; random-effects model, with a heterogeneity of I 2 = 92%; P < 0.00001; Fig. 5) (24,32,33), and BCTQ-F score at 1 year post-surgery (MD, 0.17; 95% CI, -0.02 to 0.36; P = 0.08; n = 592; random-effects model, with a heterogeneity of I 2 = 91%; P < 0.00001; Fig. 6) (24,32,33) between the ECTR and OCTR groups.…”

“…Several meta-analyses have compared various measures of efficacy and safety between ECTR and OCTR (14, [20][21][22]. However, these investigations failed to separate subgroups according to different follow-up times and utilized limited evaluations of patient outcomes; therefore, it is not clear which approach is associated with better clinical results (23,24).…”

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

“…The clinical results in demonstrated in this study are comparable, if not superior, to the existing published randomized controlled trial outcomes and meta-analysis results for ECTR. 1,[18][19][20] We acknowledge the main limitations of this study, are the small number of participants and its retrospective nature. We are also aware that there is no cohort for comparison with, such as a traditional ECTR method or OCTR.…”

Open versus endoscopic carpal tunnel release: A systematic review and meta-analysis of randomized controlled trials

“…Several meta-analyses have compared various measures of efficacy and safety between ECTR and OCTR [15,[21][22][23]. However, these investigations failed to separate subgroups according to different follow-up times and utilized limited evaluations of patient outcomes; therefore, it is not clear which approach is associated with better clinical results [24,25].…”