Return to Activities After Simultaneous Bilateral Endoscopic Carpal Tunnel Release

Abstract

Background Approximately 56% of patients diagnosed with carpal tunnel syndrome present with bilateral symptoms; however, few studies have investigated bilateral simultaneous endoscopic carpal tunnel release (ECTR) and postoperative effect on return to activity. The purpose of this study was to evaluate the length of recovery in patients who received bilateral simultaneous ECTR, including pain medication requirements, return to activities of daily living, return to work, and return to recreational activities. Methods A retrospective analysis was performed on patients who underwent bilateral ECTR by a single hand fellowship–trained surgeon from 2013 to 2019. Demographic, operative, and clinical outcomes were collected via chart review and a telephone interview. Student t tests and χ2 tests were conducted for analysis. Results Eighty patients were included in the study; 40 were successfully contacted for telephone interview follow-up. Patients reported an average of 2 days of use of postoperative narcotic pain medication and an average of 5, 7, and 19 days of return to activities of daily living, work, and recreational activities, respectively. Female patients reported more days of narcotic pain medications (1 day vs 3 days, P = .0483) and an average of longer return to work than men (9 days vs 5 days, P = .0477). Manual laborers reported longer return to work (9 days vs 5 days, P = .0500). Older patients (aged >65 years) reported longer return to recreational activities (39 days vs 11 days, P = .0189). Conclusions Simultaneous bilateral ECTR is a successful procedure with shorter recovery times than reported previously. Female patients, manual laborers, and older patients experience a longer recovery and should be counseled appropriately.

Endoscopic carpal surgery in carpal tunnel syndrome: A systematic review

“…Two studies were RCT studies by Kempton et al 18 and Truelove et al 19 . Seven studies were prospective studies, the most prevalent research design, including studies by Degeorge et al, 20 Li et al, 21 Trung et al, 22 Grandizio et al, 23 Ng et al, 24 , 25 and Rooij et al 26 Only five retrospective studies were identified, by Satteson et al, 27 Hein et al, 28 Liu and Wu, 29 Wellington et al, 30 and Tarfusser et al 31 …”

“…Anesthetic and endoscopic technique of the 12 publications that reported on anesthetic aspects, most reported the use of regional or local anesthesia. A monitored anesthesia care technique was added by Hein et al, 28 while Tarfusser et al 31 used only the wide-awake, local anesthesia, no tourniquet (WALANT) technique in all samples. Wellington et al 30 compared the outcome of monitored anesthesia care with tourniquet, (MT) 43 local anesthesia with tourniquet (LT), and WALANT.…”

“…Satteson et al 27 reported a significant difference only in incidence of neuropraxia, with higher rates occurring in the mild neuropraxia group. Hein et al, 28 using a MicroAire single-portal smart release set, reported that their patients used narcotic pain medication for only 2 days following the operation and returned to ADL in an average of 5 days. The rate of use of narcotic pain medications was higher in females than in males.…”