Outcomes and Satisfaction with Endoscopic Carpal Tunnel Releases and the Predictors - A Retrospective Cohort Study

Chen, Alvin Chao‐Yu; Wu, Meng-Huang; Cheng, Chun‐Ying; Chan, Yi‐Sheng

doi:10.2174/1874325001610010757

Cited by 10 publications

(8 citation statements)

References 17 publications

(30 reference statements)

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“…Gay et al found that the BCTQ is more sensitive to changes in clinical stats of patients than the electrophysiological findings, clinical examination or other generic questionnaires such as the Short-Form 36 and Disabilities of the Arm, Shoulder, and Hand questionnaire [12]. Some factors have been suggested as outcome predictors of carpal releasing surgery including age, gender, smoking, occupation, underlying disease, duration of symptoms, and preoperative muscle weakness or atrophy [7,8] However, in this study, most variables did not have a strong predictive value on patients' outcomes. In our study, patients with severe electrophysiological findings had higher postoperative FSS score.…”

Section: Discussionmentioning

confidence: 99%

“…We performed the Semmes-Weinstein monofilament test at the most prominent finger for each patient. Results were recorded by a 5-point scale as follows: 1-normal (2.83 monofilaments), 2-diminished light touch (3.61), 3diminished protective sensation (4.31), 4-loss of protective sensation (4.56), and 5-untestable sensation (6.65) [8]. Grip strength test was conducted using a Jamar dynamometer (Sammons Preston, Bolingbrook, Illinois) [3].…”

Section: Methodsmentioning

confidence: 99%

“…Sensory nerve action potential (SNAP) (in μv), the peak latency of SNAP (in ms), the peak amplitude of compound muscle action potential (in mV), and conduction velocity of the SNAP (in m/s) were recorded. According to the American Association of Electrodiagnostic Medicine criteria [8] patients were categorized into three groups (mild, moderate and severe).…”

Section: Methodsmentioning

confidence: 99%

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Carpal tunnel surgery: predictors of clinical outcomes and patients’ satisfaction

Alimohammadi

Bagheri

Hadidi

et al. 2020

BMC Musculoskelet Disord

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Background: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. Moreover, carpal tunnel release (CTR) surgery generally has excellent results. The present study aimed to investigate the predictors of clinical outcomes and satisfaction in patients with CTR. Methods: In this observational prospective cohort study, 152 patients with open carpal tunnel release surgery were investigated. Complete clinical examinations were performed and recorded before the surgery, two weeks after the surgery and 6 months after the surgery. The Boston Carpal Tunnel Questionnaire (BCTQ) were assessed on admission and at last follow-up visits to evaluate clinical outcomes. Patients' satisfaction was determined by a 10-point verbal descriptor nominal scale (1 = very poor, 5 = fair and 10 = excellent) and recorded during the last follow-up visits. Results: Among 152 patients who were investigated, there were 118 (77.6%) females and 34 (22.36%) males. Overall, surgery improved the outcomes based on Symptom Severity Scale (SSS) and Functional Status Scale (FSS) (P < 0.05). Most of the considered variables did not show significant effects on clinical outcomes and patients' satisfaction. However, duration of symptoms and electrophysiological severity were the predictors of the change score in SSS(P < 0.05). As well as, age was the only predictor of the change score in FSS (P < 0.05). Finally, according to the linear regression model, the pre-operative grip strength and age were the independent predictors of post-operative satisfaction (P < 0.05). Conclusions: Results of the present study revealed that there was a significant improvement in clinical outcomes after CTS surgery. Stronger pre-operative grip strength and younger age were independent predictors of higher post-operative satisfaction. These results can be used in pre-operative counseling and management of post-operative expectations.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Carpal tunnel surgery: predictors of clinical outcomes and patients’ satisfaction

Alimohammadi

Bagheri

Hadidi

et al. 2020

BMC Musculoskelet Disord

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“…In 1998, Atroshi et al found higher age to be a risk factor for low patient reported satisfaction 6 months after OCTR in a study on 128 Swedish patients (mean age 51 years, range 21-94) [29]. On the contrary, a Taiwanese study including 58 patients (mean age 50.6 years, SD = 10.54) did not find a predictive effect of age on postoperative patient satisfaction [30]. The effect of age has also been examined with other outcomes such as return to work, disability, and symptom relief, with mixed findings showing no effect of age on return to work [31], QuickDASH improvement [12], or disability [32].…”

Section: Age and Gendermentioning

confidence: 97%

Higher preoperative pain catastrophizing increases the risk of low patient reported satisfaction after carpal tunnel release: a prospective study

Mosegaard

Stilling

Hansen

2020

BMC Musculoskelet Disord

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Background: Carpal tunnel syndrome is a common upper-limb nerve compression disease. Carpal tunnel syndrome can lead to several symptoms such as tingling or numbness, pain in the hand or wrist, and reduced grip strength. Based on demographic characteristics, patient reported outcome measures, and with special attention to pain catastrophizing, the purpose of this study was to identify risk factors for low patient-reported satisfaction following surgical treatment of idiopathic carpal tunnel syndrome. Methods: A total of 417 hands from 417 patients (64. 5% females) with a mean age of 58. 0 years were included in this 1year prospective follow-up study. We collected preoperative data on disability using the Disability of the Arm, Shoulder and Hand questionnaire (DASH), quality of life using the EuroQol-5D (EQ-5D), pain catastrophizing using the Pain Catastrophizing Scale (PCS) and distal motor latency. Data on DASH score, EQ-5D, and patient satisfaction was collected 12 months postoperatively. Wilcoxon matched-pairs signed-rank test was used to test for difference in preoperative and postoperative DASH and EQ-5D score. Risk factors for low postoperative patient reported satisfaction was examined using stepwise multiple logistic regression analysis. Results: We found a general improvement in patients' DASH scores (12.29 [95% CI: 10.65-13.90], p < 0.001) and EQ-5D (0.14 [95% CI: 0.13-0.16], p < 0.001) from preoperative to 12 months postoperative. In the fully adjusted multiple regression analysis we found a statistically significant effect of preoperative PCS on patient reported satisfaction with OR = 1.05 (p = 0.022), for a one unit increase in preoperative PCS. There was no statistically significant predictive effect of preoperative EQ-5D (p = 0.869), DASH (p = 0.076), distal motor latency (p = 0.067), age (p = 0.505) or gender (p = 0.222). Conclusions: Patients improved in both DASH and EQ-5D from preoperative to 12 months postoperative. Higher preoperative PCS seems to have a negative effect on postoperative patient reported satisfaction after carpal tunnel release.

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“…Chow[ 26 ] and Agee et al[ 27 ] reported that with the widespread use of endoscopic methods, new developments in endoscopic instruments and more experienced surgeons, the postoperative morbidity is decreased, the time until return to work after the surgery is shortened, and the scars are more cosmetic and painless. However, endoscopic techniques may also lead to high complication rates when performed without adequate knowledge of endoscopic anatomy and experience[ 15 , 18 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Recurrent carpal tunnel syndrome: Evaluation and treatment of the possible causes

Eroğlu¹,

Sarı²,

Topuz³

et al. 2018

WJCC

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AIMTo investigate the causes of the recurrent carpal tunnel syndrome (CTS) and implemented surgical interventions.METHODSFour hundred and eighty-seven patients, who were diagnosed with CTS and underwent surgical intervention between October 2016 and September 2007, were evaluated in this retrospective study. The age, gender, physical evaluation findings, electrophysiological examination reports and implemented surgical treatment methods were analyzed.RESULTSThirty-nine of the cases were operated due to recurrent CTS. Further examination of the patients with recurrent CTS revealed that ten cases had diabetic polyneuropathy, three cases had hypothyroidism, two cases had rheumatoid arthritis and one case had systemic amyloidosis. Postoperative electromyography confirmed the neuropathy was due to systemic diseases. The remaining 23 patients with recurrent CTS did not have any systemic disease and all of them had applied previously to another health center.CONCLUSIONWe concluded that the recurrence rates in CTS might be decreased with exploration and incision of the entire transverse ligament. Damage to the motor and sensory branches of the median nerve could be avoided with an incision on the ulnar side.

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Outcomes and Satisfaction with Endoscopic Carpal Tunnel Releases and the Predictors - A Retrospective Cohort Study

Cited by 10 publications

References 17 publications

Carpal tunnel surgery: predictors of clinical outcomes and patients’ satisfaction

Carpal tunnel surgery: predictors of clinical outcomes and patients’ satisfaction

Higher preoperative pain catastrophizing increases the risk of low patient reported satisfaction after carpal tunnel release: a prospective study

Recurrent carpal tunnel syndrome: Evaluation and treatment of the possible causes

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