Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic Study

Final 1-Year Results of the TUTOR Randomized Trial Comparing Carpal Tunnel Release with Ultrasound Guidance to Mini-open Technique

“…The 1-year results with CTR-US in this trial corroborate the long-term results reported in single-arm CTR-US studies 8–11 that reported sustained and clinically important improvements in CTS symptoms with a low rate of complications (Table 2). In this trial, more than one in four patients assigned to mOCTR withdrew before treatment because they did not desire mOCTR despite initially consenting to randomization.…”

“…This learning curve with CTR-US is consistent with previous studies demonstrating proficiency by providers with a wide range of prior experience in ultrasound and CTR. 10,23 While the substantial difference in surgeon experience precluded statistically analyzing its impact on trial results, comparing CTR-US and mOCTR outcomes among similarly experienced surgeons would be informative.…”

“…Carpal tunnel release with ultrasound guidance (CTR-US) uses a small (<1 cm) wrist incision with real-time ultrasonography to visualize the relevant anatomy during the procedure. While numerous case series have reported favorable outcomes with CTR-US, 8–11 randomized trials provide higher-quality evidence to inform clinical decision-making. Two previous single-center randomized trials evaluated patient-reported outcomes and complication rates with CTR-US and mOCTR.…”

Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance in Over 100 Patients at Two to Six Years

“…However, our results are consistent with previous studies reporting 1-year results by a diverse group of physicians using the same technique in a typical CTS patient population. 20 , 25 Second, not all eligible patients (ie, those who were minimum 2 years post-CTR-US), participated in the study, introducing the potential for selection bias. Nonetheless, the response rate of over 50% is noteworthy for a study of this size with a minimum 2-year follow-up.…”

“… 15 , 17 , 18 , 19 Although multiple studies have demonstrated the durability of clinical improvements at 1 year post-CTR-US, only four publications by two author groups have reported longer-term outcomes for CTR-US at 2 years or more ( Table 1 ). 15 , 16 , 17 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 Further research documenting the longer-term outcomes of CTR-US will help establish the relative durability of CTR-US compared with more commonly used techniques, such as OCTR, mOCTR, and ECTR ( Table 1 ). Therefore, the primary purpose of the current study was to determine the clinical results of CTR-US at a minimum of 2 years postprocedure in a large group of over 100 patients.…”