Age is an important predictor of short-term outcome in endoscopic carpal tunnel release

Abstract

Endoscopic carpal tunnel release is a minimally invasive technique that may reduce sick leave and facilitate postoperative rehabilitation and short-term outcome. The aim of this study was to investigate the influence of age as a predictor of short-term outcome in endoscopic carpal tunnel release. We did a prospective registration of patient satisfaction, symptoms and function before and 2-months after endoscopic carpal tunnel release in 101 consecutive patients aged 23-94 years and then submitted the data to multivariable logistic regression analysis. Patient age >65 years was a good predictor of a less favourable short-term outcome, and endoscopic carpal tunnel release may not be justified as a routine procedure in elderly patients.

Improvement in Patient-Specific Outcomes After Carpal Tunnel Release in Patients Older Than 80 Years

“…Outcome measures were used that created bias; any nonperfect BWQ score was considered a negative event. 6 Finally, previous studies drawing conclusions on age and BWQ contained small cohorts (<20 patients). 6,[12][13][14] Other investigators have shown less improvement in both symptoms and function after CTR in older patients.…”

“…6 Finally, previous studies drawing conclusions on age and BWQ contained small cohorts (<20 patients). 6,[12][13][14] Other investigators have shown less improvement in both symptoms and function after CTR in older patients. 15 For these reasons, CTR in "super elderly" patients has become controversial.…”

“…5 Recent studies after CTR in patients older than 65 years have shown mixed results in self-reported symptom severity and functional status outcomes. [6][7][8] As a result, controversy exists regarding surgical treatment in older persons, especially those with severe, chronic disease. There is a paucity of data regarding outcomes of CTR in patients older than 80 years.…”

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

“…That is because CTS not only affects the function but also the psychosocial aspect. Previous studies had tried to predict outcome with various factors including age [4], underlying disease [5], occupation [6], response to preoperative steroid injection [7], duration of symptoms [3], preoperative clinical features such as nocturnal pain and bilateral pain [11], preoperative muscle weakness or atrophy, worker’s compensation [2], incorrect diagnosis, and incomplete release of the transverse carpal ligament [12]. All these factors can be explained to patient in advance in order to prevent unwanted dissatisfaction.…”

“…In spite of effective symptom release and early return to work, patient’s satisfaction with endoscopic carpal tunnel release (ECTR) is still unpredictable [3]. Many factors have been proposed as outcome predictors of carpal tunnel release include age [4], underlying disease [5], occupation [6], response to preoperative steroid injection [7], duration of symptoms [3], preoperative clinical features such as nocturnal pain and bilateral pain [11], preoperative muscle weakness or atrophy, worker’s compensation [2], incorrect diagnosis [12] and incomplete release of the transverse carpal ligament [12]. The Boston CTS questionnaire is a well-recognized, disease-specific, validated self-administered questionnaire in CTS [8].…”