The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study
Patients with failure of primary surgery for carpal tunnel syndrome (CTS) present a frustrating clinical problem because there are no relevant treatment guidelines, and the effect of current conservative management or revision surgery is unsatisfactory. Hydrodissection with 5% dextrose is emerging a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/13/3705 |
| _version_ | 1797408852029734912 |
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| author | Ta-Chung Chao Kenneth Dean Reeves King Hei Stanley Lam Tsung-Ying Li Yung-Tsan Wu |
| author_facet | Ta-Chung Chao Kenneth Dean Reeves King Hei Stanley Lam Tsung-Ying Li Yung-Tsan Wu |
| author_sort | Ta-Chung Chao |
| collection | DOAJ |
| description | Patients with failure of primary surgery for carpal tunnel syndrome (CTS) present a frustrating clinical problem because there are no relevant treatment guidelines, and the effect of current conservative management or revision surgery is unsatisfactory. Hydrodissection with 5% dextrose is emerging as an effective treatment for primary CTS and may be an effective alternative treatment method for persistent or recurrent post-surgical CTS. We retrospectively investigated the long-term effectiveness of hydrodissection with 5% dextrose for persistent or recurrent CTS. Thirty-six of forty consecutively-treated patients with either persistent or recurrent symptoms of CTS after surgery, who were treated with ultrasound-guided hydrodissection of the median nerve using 10 mL of 5% dextrose, were available to provide outcome data by a structured phone interview at least six months after treatment completion. Symptom relief ≥ 50% represented an effective outcome, while symptom relief < 50% was rated as a poor outcome. Nearly 2/3 (61.1%) of patients reported an effective outcome after a mean of 3.1 injections, with a post-injection follow-up mean of 33 (6–67) months. A non-significant trend toward a more frequently-effective outcome was observed in those with recurrent versus persistent symptoms following CTS (76.9% vs. 52.2%, <i>p</i> = 0.165). However, a significantly higher percentage of those with recurrent symptoms reported an excellent outcome, defined as a greater than 70% improvement (8/13 [61.6%] vs. 3/23 [13%], <i>p</i> = 0.006). The percentage of patients achieving an effective outcome was not significantly different between <2, 2–4, and >4 years of post-treatment follow-up (36.4% vs. 77.8% vs. 57.1%; <i>p</i> = 0.077). Hydrodissection with 5% dextrose may result in a clinically important and durable benefit in those experiencing persistent or recurrent CTS after surgery. |
| first_indexed | 2024-03-09T04:04:36Z |
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| id | doaj.art-736b50d2173f4d6392d190847a60525a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T04:04:36Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-736b50d2173f4d6392d190847a60525a2023-12-03T14:07:48ZengMDPI AGJournal of Clinical Medicine2077-03832022-06-011113370510.3390/jcm11133705The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective StudyTa-Chung Chao0Kenneth Dean Reeves1King Hei Stanley Lam2Tsung-Ying Li3Yung-Tsan Wu4Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, TaiwanPrivate Practice PM&R and Pain Management, Roeland Park, KS 662, USAThe Hong Kong Institute of Musculoskeletal Medicine, Hong KongDepartment of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, TaiwanDepartment of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, TaiwanPatients with failure of primary surgery for carpal tunnel syndrome (CTS) present a frustrating clinical problem because there are no relevant treatment guidelines, and the effect of current conservative management or revision surgery is unsatisfactory. Hydrodissection with 5% dextrose is emerging as an effective treatment for primary CTS and may be an effective alternative treatment method for persistent or recurrent post-surgical CTS. We retrospectively investigated the long-term effectiveness of hydrodissection with 5% dextrose for persistent or recurrent CTS. Thirty-six of forty consecutively-treated patients with either persistent or recurrent symptoms of CTS after surgery, who were treated with ultrasound-guided hydrodissection of the median nerve using 10 mL of 5% dextrose, were available to provide outcome data by a structured phone interview at least six months after treatment completion. Symptom relief ≥ 50% represented an effective outcome, while symptom relief < 50% was rated as a poor outcome. Nearly 2/3 (61.1%) of patients reported an effective outcome after a mean of 3.1 injections, with a post-injection follow-up mean of 33 (6–67) months. A non-significant trend toward a more frequently-effective outcome was observed in those with recurrent versus persistent symptoms following CTS (76.9% vs. 52.2%, <i>p</i> = 0.165). However, a significantly higher percentage of those with recurrent symptoms reported an excellent outcome, defined as a greater than 70% improvement (8/13 [61.6%] vs. 3/23 [13%], <i>p</i> = 0.006). The percentage of patients achieving an effective outcome was not significantly different between <2, 2–4, and >4 years of post-treatment follow-up (36.4% vs. 77.8% vs. 57.1%; <i>p</i> = 0.077). Hydrodissection with 5% dextrose may result in a clinically important and durable benefit in those experiencing persistent or recurrent CTS after surgery.https://www.mdpi.com/2077-0383/11/13/3705dextrosecarpal tunnel syndromehydrodissectionsurgery |
| spellingShingle | Ta-Chung Chao Kenneth Dean Reeves King Hei Stanley Lam Tsung-Ying Li Yung-Tsan Wu The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study Journal of Clinical Medicine dextrose carpal tunnel syndrome hydrodissection surgery |
| title | The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study |
| title_full | The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study |
| title_fullStr | The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study |
| title_full_unstemmed | The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study |
| title_short | The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study |
| title_sort | effectiveness of hydrodissection with 5 dextrose for persistent and recurrent carpal tunnel syndrome a retrospective study |
| topic | dextrose carpal tunnel syndrome hydrodissection surgery |
| url | https://www.mdpi.com/2077-0383/11/13/3705 |
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