Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic Study
Purpose: The purpose of this study was to report the 1-year clinical outcomes of carpal tunnel release using ultrasound guidance (CTR-US) performed in a large, real-world population of patients enrolled in a multicenter registry. Methods: All patients who participated in a postmarket registry study...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Journal of Hand Surgery Global Online |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589514123001688 |
| _version_ | 1827377911545462784 |
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| author | Demetrio Aguila, MD Matthew Kirsch, MD Brett Kindle, MD Paul Paterson, MD |
| author_facet | Demetrio Aguila, MD Matthew Kirsch, MD Brett Kindle, MD Paul Paterson, MD |
| author_sort | Demetrio Aguila, MD |
| collection | DOAJ |
| description | Purpose: The purpose of this study was to report the 1-year clinical outcomes of carpal tunnel release using ultrasound guidance (CTR-US) performed in a large, real-world population of patients enrolled in a multicenter registry. Methods: All patients who participated in a postmarket registry study of CTR-US outcomes and provided both preoperative and 1-year postoperative data were included. Main outcomes were the Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (QDASH), Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS), and Boston Carpal Tunnel Functional Status Scale (BCTQ-FSS) scores at 1 year. Subgroup analysis was performed to assess the effect of patient and procedural factors on 1-year outcomes. Results: A total of 300 patients (341 hands) were treated by 25 different physicians, including 41 (13.7%) treated with simultaneous bilateral procedures. Mean patient age was 54.2 years, 63% were women, 24% had ≥2 comorbidities, and 54% had symptoms for >2 years. Mean QDASH scores decreased from 40.6 ± 20.6 to 12.2 ± 18.3 at 1 year, BCTQ-SSS scores decreased from 3.0 ± 0.7 to 1.5 ± 0.7 at 1 year, and BCTQ-FSS scores decreased from 2.4 ± 0.8 to 1.4 ± 0.6 at 1 year. Women improved more than men at 1 year for QDASH, BCTQ-SSS, and BCTQ-FSS. Patients treated with simultaneous bilateral procedures had similar 1-year outcomes to those treated with unilateral procedures. Multiple other factors including high body mass index, diabetes status, current tobacco use, rheumatoid/inflammatory arthritis, operation in the dominant hand, higher comorbidity burden, and concurrent ipsilateral procedures did not significantly affect 1-year outcomes. Two patients had revision surgeries in addition to one patient with an infection, and one with a suspected small finger tendon injury. Conclusions: Patients treated with CTR-US in real-world conditions report significant and clinically meaningful improvements in symptoms and function that are maintained at 1 year. The results are consistent across broad patient demographics and are not affected by performing simultaneous bilateral procedures. Type of study/level of evidence: Therapeutic IV. |
| first_indexed | 2024-03-08T12:47:15Z |
| format | Article |
| id | doaj.art-4ebdcae8f7bc4fd9b8f3dfa21a3eab35 |
| institution | Directory Open Access Journal |
| issn | 2589-5141 |
| language | English |
| last_indexed | 2024-03-08T12:47:15Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Hand Surgery Global Online |
| spelling | doaj.art-4ebdcae8f7bc4fd9b8f3dfa21a3eab352024-01-21T05:10:05ZengElsevierJournal of Hand Surgery Global Online2589-51412024-01-01617984Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic StudyDemetrio Aguila, MD0Matthew Kirsch, MD1Brett Kindle, MD2Paul Paterson, MD3Total Pain Solutions, Papillion, NE; Corresponding author: Demetrio Aguila, MD, Total Pain Solutions, 701 Pinnacle Drive, Suite 107, Papillion, NE 68046.Olmsted Medical Center, Rochester, MNAndrews Institute for Orthopaedics and Sports Medicine, Gulf Breeze, FLVero Beach Orthopaedics, Vero Beach, FLPurpose: The purpose of this study was to report the 1-year clinical outcomes of carpal tunnel release using ultrasound guidance (CTR-US) performed in a large, real-world population of patients enrolled in a multicenter registry. Methods: All patients who participated in a postmarket registry study of CTR-US outcomes and provided both preoperative and 1-year postoperative data were included. Main outcomes were the Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (QDASH), Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS), and Boston Carpal Tunnel Functional Status Scale (BCTQ-FSS) scores at 1 year. Subgroup analysis was performed to assess the effect of patient and procedural factors on 1-year outcomes. Results: A total of 300 patients (341 hands) were treated by 25 different physicians, including 41 (13.7%) treated with simultaneous bilateral procedures. Mean patient age was 54.2 years, 63% were women, 24% had ≥2 comorbidities, and 54% had symptoms for >2 years. Mean QDASH scores decreased from 40.6 ± 20.6 to 12.2 ± 18.3 at 1 year, BCTQ-SSS scores decreased from 3.0 ± 0.7 to 1.5 ± 0.7 at 1 year, and BCTQ-FSS scores decreased from 2.4 ± 0.8 to 1.4 ± 0.6 at 1 year. Women improved more than men at 1 year for QDASH, BCTQ-SSS, and BCTQ-FSS. Patients treated with simultaneous bilateral procedures had similar 1-year outcomes to those treated with unilateral procedures. Multiple other factors including high body mass index, diabetes status, current tobacco use, rheumatoid/inflammatory arthritis, operation in the dominant hand, higher comorbidity burden, and concurrent ipsilateral procedures did not significantly affect 1-year outcomes. Two patients had revision surgeries in addition to one patient with an infection, and one with a suspected small finger tendon injury. Conclusions: Patients treated with CTR-US in real-world conditions report significant and clinically meaningful improvements in symptoms and function that are maintained at 1 year. The results are consistent across broad patient demographics and are not affected by performing simultaneous bilateral procedures. Type of study/level of evidence: Therapeutic IV.http://www.sciencedirect.com/science/article/pii/S2589514123001688Carpal tunnel releaseCarpal tunnel syndromeMedian nerveMinimally invasiveUltrasound |
| spellingShingle | Demetrio Aguila, MD Matthew Kirsch, MD Brett Kindle, MD Paul Paterson, MD Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic Study Journal of Hand Surgery Global Online Carpal tunnel release Carpal tunnel syndrome Median nerve Minimally invasive Ultrasound |
| title | Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic Study |
| title_full | Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic Study |
| title_fullStr | Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic Study |
| title_full_unstemmed | Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic Study |
| title_short | Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic Study |
| title_sort | long term clinical results of carpal tunnel release using ultrasound guidance a multicenter pragmatic study |
| topic | Carpal tunnel release Carpal tunnel syndrome Median nerve Minimally invasive Ultrasound |
| url | http://www.sciencedirect.com/science/article/pii/S2589514123001688 |
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