Office-Based Carpal Tunnel Release With Ultrasound Guidance: 6-month Outcomes From the Multicenter ROBUST Trial

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures
• Ultrasound-Guided Interventions

Background:

• Carpal tunnel syndrome (CTS) is a common condition causing hand pain and numbness.
• Traditional carpal tunnel release (CTR) often requires open surgery.
• Office-based procedures offer potential for increased patient convenience and reduced costs.

Purpose of the Study:

• To evaluate the safety and effectiveness of office-based carpal tunnel release with ultrasound guidance (CTR-US).
• To assess patient outcomes including recovery time, symptom improvement, and satisfaction.

Main Methods:

• A prospective, multicenter observational study involving 149 participants (226 hands).
• Office-based CTR-US performed under wide-awake local anesthesia without a tourniquet.
• Outcomes measured included return to daily activities and work, validated questionnaires (BCTQ, MHQ, NPS, EQ-5D), and adverse events over 6 months.

Main Results:

• All procedures were completed successfully with a mean incision length of 5mm.
• Median recovery to normal activities was 2 days and return to work was 4 days.
• Significant improvements were observed in BCTQ, MHQ, NPS, and EQ-5D scores, with 94% procedure satisfaction and only one adverse event (0.4%).

Conclusions:

• Office-based CTR-US is a well-tolerated procedure with a low complication rate.
• The technique facilitates rapid recovery, sustained functional improvement, and high patient satisfaction.
• Both unilateral and simultaneous bilateral CTR-US demonstrated similar effectiveness.