The Preoperative Cost of Carpal Tunnel Syndrome

Greenfield, Paul T.; Spencer, Corey C.; Dawes, Alexander; Wagner, Eric R.; Gottschalk, Michael B.; Daly, Charles A.

doi:10.1016/j.jhsa.2021.07.027

Cited by 20 publications

(11 citation statements)

References 35 publications

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“…Carpal tunnel release is a common surgery with approximately 600,000 procedures performed each year in the United States alone [ 1 , 23 ]. However, only 2% of these procedures are currently performed in an office setting [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Protocol of a Multicenter Prospective Trial of Office-Based Carpal Tunnel Release With Ultrasound Guidance (ROBUST)

Pistorio¹,

Chung²,

Miller³

et al. 2023

Cureus

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Background Carpal tunnel release (CTR) is a common surgical procedure for patients with severe or refractory carpal tunnel syndrome (CTS) symptoms. Historically, CTR procedures have been performed in a hospital or an ambulatory surgery center (ASC). However, due to advancements in techniques, greater patient demand, and concerns about growing healthcare costs, there is a distinct trend toward performing CTR procedures in an office-based setting. Several small studies with limited follow-up duration have demonstrated the feasibility of CTR with ultrasound guidance (CTR-US) when performed in an office-based setting. The objective of this study is to evaluate the safety and effectiveness of office-based CTR-US in a large cohort of patients (n=140) with symptomatic CTS followed for two years post-treatment. Design and methods ROBUST is a prospective multicenter observational study in which 140 subjects at up to 12 sites in the United States will be treated with CTR-US in an office-based setting. The primary endpoint of the study is the change in the Boston Carpal Tunnel Questionnaire Symptom Severity Scale score. Secondary endpoints include time to return to normal daily activities, time to return to work among employed subjects, change in the Boston Carpal Tunnel Questionnaire Functional Status Scale score, change in the Michigan Hand Questionnaire overall and domain scores, change in the Numeric Pain Scale score, change in the EuroQoL-5 Dimension 5-Level score, global satisfaction scores, and the incidence of device or procedure-related adverse events. The primary analysis of study endpoints will occur three months post-treatment. Patient follow-up in this study will continue for two years. Conclusions A central institutional review board approved the study protocol, and a data safety monitoring board will provide study oversight. The authors plan to report study results at medical conferences and in peer-reviewed medical journals. The outcomes of ROBUST will provide physicians, patients, and payors with important safety and effectiveness data regarding the clinical utility of CTR-US when performed in an office setting.

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Section: Discussionmentioning

confidence: 99%

Protocol of a Multicenter Prospective Trial of Office-Based Carpal Tunnel Release With Ultrasound Guidance (ROBUST)

Pistorio¹,

Chung²,

Miller³

et al. 2023

Cureus

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show abstract

“…Procedure rooms are less expensive and more efficient. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 The savings begin before the patient steps foot in the procedure room, with no need for preoperative laboratory testing and medical evaluations. In a study of preoperative carpal tunnel patients, Greenfield et al 8 found a per-patient average cost of $858.74 was spent on preoperative work-ups and nonsurgical management of patients who underwent carpal tunnel release.…”

Section: Discussionmentioning

confidence: 99%

“… 6 It saves the patient time and money by eliminating the need for a preoperative evaluation and time off work. 8 Additionally, there are cost savings associated with the decreased need for surgical drapes, equipment, and hospital staffing. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 There is also a decrease in the waste generated by these procedures, as they are typically done under minor field sterility, which consists of sterile prep, a single drape, a minor instrument tray, sterile gloves and a mask (no gown or antibiotics), and local anesthesia.…”

mentioning

confidence: 99%

“… 8 Additionally, there are cost savings associated with the decreased need for surgical drapes, equipment, and hospital staffing. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 There is also a decrease in the waste generated by these procedures, as they are typically done under minor field sterility, which consists of sterile prep, a single drape, a minor instrument tray, sterile gloves and a mask (no gown or antibiotics), and local anesthesia. 16 , 29 …”

mentioning

confidence: 99%

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Wide-Awake Hand Surgery Has Its Benefits: A Study of 1,011 Patients

McKnight¹,

Smith²,

MacFadden³

et al. 2022

Journal of Hand Surgery Global Online

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“…Ultrasound and the CTS-6 have both been shown to be more sensitive and specific in diagnosing CTS than EDS 7 . In a database study, EDS represented nearly one-half (44.6%) of the cost of the preoperative care in 378,381 patients with CTS 8 . This information, along with the known delays in care when using EDS as a diagnostic tool 4 , makes the usefulness of EDS for the routine diagnosis of CTS questionable at best.…”

Section: Carpal Tunnel Syndromementioning

confidence: 99%

What’s New in Hand and Wrist Surgery

Bohn

2023

Journal of Bone and Joint Surgery

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The Preoperative Cost of Carpal Tunnel Syndrome

Cited by 20 publications

References 35 publications

Protocol of a Multicenter Prospective Trial of Office-Based Carpal Tunnel Release With Ultrasound Guidance (ROBUST)

Protocol of a Multicenter Prospective Trial of Office-Based Carpal Tunnel Release With Ultrasound Guidance (ROBUST)

Wide-Awake Hand Surgery Has Its Benefits: A Study of 1,011 Patients

What’s New in Hand and Wrist Surgery

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