Endoscopic release of the carpal tunnel: a randomized prospective multicenter study

Area of Science:

• Orthopedics
• Minimally Invasive Surgery
• Hand Surgery

Background:

• Carpal tunnel syndrome (CTS) is a common condition causing hand pain and numbness.
• Open surgical release of the transverse carpal ligament is the traditional treatment.
• There is a need for less invasive and more efficient surgical options.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel endoscopic device for carpal tunnel release.
• To compare recovery times and outcomes between endoscopic and open carpal tunnel surgery.

Main Methods:

• A prospective, randomized, multicenter study involving 122 patients with CTS.
• Patients were randomized to undergo either endoscopic release using a new device or conventional open surgery.
• The endoscopic device utilized a trigger-activated blade coupled with fiberoptic light and a video camera.

Main Results:

• The endoscopic device group showed a median return to work time 21.5 days shorter than the open surgery group for patients with unilateral CTS.
• Postoperative strength and tenderness were the best predictors of return to work and daily activities.
• Two patients in the endoscopic group required reoperation, one for incomplete release, and two experienced transient ulnar neurapraxia.

Conclusions:

• Endoscopic carpal tunnel release with the described device offers a faster return to work compared to open surgery.
• The device is a viable alternative for carpal tunnel surgery, though potential complications like incomplete release and neurapraxia should be monitored.
• Further research may optimize the technique to minimize reoperations and transient nerve issues.