Outcomes of open and endoscopic carpal tunnel release: a meta-analysis

Kohanzadeh, Som; Herrera, Fernando; Dobke, Marek

doi:10.1007/s11552-012-9413-5

Cited by 36 publications

(29 citation statements)

References 37 publications

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“…26 Between endoscopic and open procedures, the rates of CRPS development were nearly identical which is consistent with previously reported trends in the literature. [12][13][14][15] This establishes that the choice between an open or endoscopic technique for carpal tunnel release should not be made over concern of CRPS. Differences between the two techniques primarily lie in their different functional outcomes, recovery rates, and cost.…”

Section: Discussionmentioning

confidence: 99%

“…Differences between the two techniques primarily lie in their different functional outcomes, recovery rates, and cost. 15,23,27 Within the privately insured population, rates of CTR have increased by approximately 200% since 2007, and CRPS following CTR has approximately doubled. The rates of the Medicare population were relatively constant.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 Other attempts to compare complication rates of the open and endoscopic techniques have been similarly inconclusive, as a meta-analysis by Kohanzadeh et al found that complications were the only outcome in which the two techniques did not vary. 15 There is limited literature from multiple centers that compares CRPS rates after open and endoscopic CTR. 13,14 Current patient factors that correlate with the development of CRPS are difficult to detect and diagnose (i.e., abnormal brain structure and altered signaling pathways).…”

mentioning

confidence: 99%

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National Trends in the Diagnosis of CRPS after Open and Endoscopic Carpal Tunnel Release

Mertz

Trunzter

et al. 2019

Jnl Wrist Surg

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Background Complex regional pain syndrome (CRPS) occurs in 2 to 8% of patients that receive open or endoscopic carpal tunnel release (CTR). Because CRPS is difficult to treat after onset, identifying risk factors can inform prevention. We determined the incidence of CRPS following open and endoscopic CTR using a national claims database. We also examined whether psychosocial conditions were associated with CRPS after CTR. Methods We accessed insurance claims using diagnostic and procedural codes. We calculated the incidence of CRPS following open carpal tunnel release and endoscopic carpal tunnel release within 1 year. The response variable was the presence of CRPS after CTR. Explanatory variables included procedure type, age, gender, and preoperative diagnosis of anxiety or depression. Results The number of open CTRs (85% of total) outweighs the number of endoscopic procedures. In younger patients, the percentage of endoscopic CTRs is increasing. Rates of CRPS are nearly identical between surgery types for both privately insured (0.3%) and Medicare patients (0.1%). Middle aged (range: 40–64 years) and female patients had significantly higher rates of CRPS than did the general population. Preoperative psychosocial conditions did not correlate with the presence of CRPS in surgical patients. Clinical Relevance The decision between endoscopic and open CTR should not be made out of concern for development of CRPS postsurgery, as rates are low and similar for both procedures. Rates of CRPS found in this study are much lower than rates found in previous studies, indicating inconsistency in diagnosis and reporting or generalizability of prior work. Preoperative psychosocial disorders and CRPS are unrelated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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National Trends in the Diagnosis of CRPS after Open and Endoscopic Carpal Tunnel Release

Mertz

Trunzter

et al. 2019

Jnl Wrist Surg

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“…[10]. CTS is usually treated by surgical decompression with generally favourable long-lasting outcomes [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Patient-reported outcomes of carpal tunnel syndrome surgery in a non-industrial area

Kogut

Glinkowski

2019

Ann Agric Environ Med.

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Introduction and objective. This study aimed to determine the environmental conditions for the occurrence of carpal tunnel syndrome (CTS) in a non-industrial area, and patient-reported outcomes after surgical release. Materials and method. This observational study utilized convenience sampling to screen 100 consecutive patients for carpal tunnel syndrome at the Orthopedic Clinic, using two questionnaires. Data were collected from the Disability of Arm Shoulder and Hand (DASH) questionnaire, and the PROMIS® (Patient-Reported Outcomes Measurement Information System) Upper Extremity and PROMIS® SF 3a questionnaire (Pain Intensity). The relationship of various repetitive musculoskeletal disorders to CTS was validated by questionnaire scores, PROMIS® T-score, and correlation coefficients. Results. Finally, CTS was confirmed by electromyography in 69 patients (55 females and 14 males; average age: 47.5 years). Aging significantly influenced the occurrence of symptoms associated with pain (neck, thoracic, lower back, shoulder, and CTS (p<0.001)). Those employed for longer more frequently declared performing exercises to prevent overload pain (p<0.001). DASH results significantly correlated with the PROMIS Upper Extremity score (r =-0.64; p<0.05). Conclusions. Geographical and environmental conditions indicate that even though working with a computer is described as an essential risk factor for CTS, the study group showed a predominance of elements that were unrelated to working at a computer. CTS also occurred among people working physically, and even among unemployed individuals. The existence of a statistically significant, strong, negative correlation (r=-0.64; p < 0.05) between the results obtained in the questionnaires DASH and PROMIS Upper Extremity has been demonstrated.

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“…5 However, ECTR has been shown to result in earlier return to work, 25 faster return of grip strength, 26 and fewer wound complications. 11 Despite this, OCTR is more commonly performed than ECTR. 20 When managing severe CTS, OCTR is generally preferred.…”

Section: Introductionmentioning

confidence: 99%

Improved Surgical Outcomes With Endoscopic Carpal Tunnel Release in Patients With Severe Median Neuropathy

Calotta¹,

Lopez²,

Deune³

2016

Hand (New York, N,Y.)

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Outcomes of open and endoscopic carpal tunnel release: a meta-analysis

Cited by 36 publications

References 37 publications

National Trends in the Diagnosis of CRPS after Open and Endoscopic Carpal Tunnel Release

National Trends in the Diagnosis of CRPS after Open and Endoscopic Carpal Tunnel Release

Patient-reported outcomes of carpal tunnel syndrome surgery in a non-industrial area

Improved Surgical Outcomes With Endoscopic Carpal Tunnel Release in Patients With Severe Median Neuropathy

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