Ultrasound-guided percutaneous carpal tunnel release: 2-year follow-up of 641 hands

Wang, Ping-Hui; Wu, Po‐Ting; Jou, I‐Ming

doi:10.1177/1753193420948824

Cited by 11 publications

(36 citation statements)

References 3 publications

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“…There were four case-cohort UPCTR studies [ 17 , 70 , 71 , 72 ]: one compared UPCTR with mini-OCTR [ 17 ]; one investigated UPCTR vs. OCTR [ 72 ]; one evaluated UPCTR using a 22 G hypodermic needle vs. UPCTR plus corticosteroid injection [ 70 ]; and the last case-cohort study compared the use of a UPCTR of an uncoated multifilament stainless steel wire looped thread with no interventions [ 71 ]. Among 16 case series [ 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 ], six investigated the effects of different hook knives [ 76 , 79 , 81 , 82 , 87 , 89 ], five evaluated the use of microknives [ 80 , 83 , 85 , 86 , 88 ], two analyzed loop threads [ 77 , 78 ], one assessed a microblade [ 84 ], and one investigated an 18 G needle with a tip bent in the opposite direction to the needle bevel [ 90 ].…”

Section: Resultsmentioning

confidence: 99%

Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses

Lam

Reeves

et al. 2023

Diagnostics

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Carpal tunnel syndrome (CTS) is the most common peripheral entrapment, and recently, ultrasound-guided perineural injection (UPIT) and percutaneous flexor retinaculum release (UPCTR) have been utilized to treat CTS. However, no systematic review or meta-analysis has included both intervention types of ultrasound-guided interventions for CTS. Therefore, we performed this review using four databases (i.e., PubMed, EMBASE, Scopus, and Cochrane) to evaluate the quality of evidence, effectiveness, and safety of the published studies on ultrasound-guided interventions in CTS. Among sixty studies selected for systemic review, 20 randomized treatment comparison or controlled studies were included in six meta-analyses. Steroid UPIT with ultrasound guidance outperformed that with landmark guidance. UPIT with higher-dose steroids outperformed that with lower-dose steroids. UPIT with 5% dextrose in water (D5W) outperformed control injection and hydrodissection with high-volume D5W was superior to that with low-volume D5W. UPIT with platelet-rich plasma outperformed various control treatments. UPCTR outperformed open surgery in terms of symptom improvement but not functional improvement. No serious adverse events were reported in the studies reviewed. The findings suggest that both UPIT and UPCTR may provide clinically important benefits and appear safe. Further treatment comparison studies are required to determine comparative therapeutic efficacy.

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Section: Resultsmentioning

confidence: 99%

Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses

Lam

Reeves

et al. 2023

Diagnostics

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“…All patients tolerated the simultaneous procedures in the office-based procedure room, and there was no significant difference in clinical outcomes between hands treated as part of simultaneous procedures compared to unilateral or staged bilateral procedures. Only two of the previously mentioned seven long-term studies specifically report performing simultaneous bilateral releases [ 19 , 20 ]. Leiby et al treated 50 hands in 25 patients in either an ambulatory surgery center or hospital operating room [ 19 ], and more recently Wang et al treated 86 hands in 43 patients in a hospital setting [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Only two of the previously mentioned seven long-term studies specifically report performing simultaneous bilateral releases [ 19 , 20 ]. Leiby et al treated 50 hands in 25 patients in either an ambulatory surgery center or hospital operating room [ 19 ], and more recently Wang et al treated 86 hands in 43 patients in a hospital setting [ 20 ]. As with the current study, Leiby et al found no significant differences in outcomes between simultaneous bilateral releases and the other groups at one-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…As with the current study, Leiby et al found no significant differences in outcomes between simultaneous bilateral releases and the other groups at one-year follow-up. Although Wang et al did not specifically present outcomes based on procedure type, they did not specifically identify simultaneous bilateral procedures as being problematic [ 20 ]. Collectively, the results of these studies support the feasibility of performing simultaneous bilateral CTRs using US guidance in multiple practice settings, including the office procedure room as documented in the current study.…”

Section: Discussionmentioning

confidence: 99%

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Office-Based Carpal Tunnel Release Using Ultrasound Guidance in a Community Setting: Long-Term Results

Bergum¹,

Ciota²

2022

Cureus

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Objectives: To report the safety and effectiveness of office-based carpal tunnel release (CTR) using ultrasound (US) guidance in a general community population. Methods: This was a prospective single-center study that evaluated patients treated with CTR using US guidance between March 2019 and August 2020 for whom one-year data were available. Procedures were performed in an office-based procedure room using local anesthesia. Main outcomes of this study included complications, Boston Carpal Tunnel Questionnaire scores (BCTQ-SSS, BCTQ-FSS) and Quick Disabilities of the Shoulder and Hand (QDASH) scores. Results: Among 88 patients (123 hands) aged 30 to 89 years with available one-year data, 29 patients had simultaneous bilateral procedures. No intraoperative complications were reported. Statistically significant and clinically important improvements in BCTQ-SSS, BCTQ-FSS and QDASH scores occurred within two weeks and persisted through one year of follow-up (p < 0.001). Outcomes were similar for simultaneous bilateral releases. During follow-up, one patient developed complex regional pain syndrome that was successfully treated and subsequently had CTR using US guidance on the contralateral hand. No other complications were observed during one-year follow-up. Conclusion: Office-based CTR using US guidance is safe, effective and provides sustained clinical improvements at one-year follow-up in a community population. Simultaneous bilateral procedures were well-tolerated and resulted in similar clinical improvements.

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“…Then, the transducer was turned transversely to make sure again that the tip of the CTP measurement gauge was next to the median nerve, within the carpal tunnel, and at the same level as the hamate hook ( Figure 1 d). After the preoperative CTP measurement, the entire transverse carpal ligament was released by an ultrasound-guided operation under local anesthesia, similar to our previous study [ 18 , 19 , 20 ] ( Figure 1 e). After percutaneous UCTR surgery was performed, the postoperative CTP was immediately measured again ( Figure 1 f).…”

Section: Methodsmentioning

confidence: 88%

The Correlation of Carpal Tunnel Pressure with Clinical Outcomes following Ultrasonographically-Guided Percutaneous Carpal Tunnel Release

Wang

et al. 2022

JPM

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Background: To evaluate the correlation between carpal tunnel pressure (CTP) and the clinical presentations, and to explore the possible predictors for the postoperative recovery pattern in patients with carpal tunnel syndrome (CTS). Materials and Methods: Consecutive patients with idiopathic CTS following percutaneous ultrasound-guided carpal tunnel release (UCTR) were enrolled. CTP was measured preoperatively and immediately after operation. The Boston Carpal Tunnel Questionnaire (BCTQ) and the cross-sectional area (CSA) of median nerve were recorded preoperatively and at 1, 3, and 12 months postoperatively. Results: 37 patients (37 hands; 8 men and 29 females; median age, 59.0 years) were enrolled. CTP significantly decreased immediately from 40.0 (28.0–58.0) to 13.0 (8.0–20.0) mmHg after UCTR. BCTQ scores significantly improved at 1 month postoperatively, and the improvement trend persisted until 12 months postoperatively (p < 0.001). Preoperative CTP was positively correlated with preoperative CSA and preoperative BCTQ scores (p < 0.05, all). Using group-based trajectory modeling, all patients were categorized into the “gradual recovery” or “fast recovery” group. Higher preoperative CTP was significantly associated with a faster recovery pattern (odds ratio: 1.32). Conclusions: Preoperative CTP was well correlated with the clinical presentations and might be a useful predictor for the postoperative clinical recovery pattern.

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Ultrasound-guided percutaneous carpal tunnel release: 2-year follow-up of 641 hands

Cited by 11 publications

References 3 publications

Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses

Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses

Office-Based Carpal Tunnel Release Using Ultrasound Guidance in a Community Setting: Long-Term Results

The Correlation of Carpal Tunnel Pressure with Clinical Outcomes following Ultrasonographically-Guided Percutaneous Carpal Tunnel Release

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