Reoperation Rates and Short-Term Complications Following Endoscopic Versus Open Carpal Tunnel Release: A Longitudinal...

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Surgical Outcomes Research

Background:

• Carpal tunnel syndrome (CTS) affects ~8% of the population.
• Open carpal tunnel release (oCTR) and endoscopic carpal tunnel release (eCTR) are common treatments.
• Existing research on CTS treatment outcomes is limited to 1-2 year follow-ups.

Purpose of the Study:

• To compare long-term reoperation rates (>5 years) of oCTR versus eCTR.
• To evaluate short-term postoperative complications (90-day) associated with oCTR and eCTR.
• To provide evidence-based guidance on surgical interventions for CTS.

Main Methods:

• Retrospective analysis of the TriNetX Research Network (2007-2024).
• Inclusion of patients with unilateral CTS undergoing oCTR or eCTR within 1 year of diagnosis.
• Propensity score matching and logistic regression to analyze reoperation rates and 90-day complications (wound dehiscence, SSI).

Main Results:

• Higher reoperation rates for eCTR within 2 years (RR=1.15), but similar rates beyond 5 years (RR=0.85).
• eCTR associated with reduced 90-day wound dehiscence (RR=0.67) and surgical site infections (SSI) (RR=0.77).
• Number needed to treat to prevent one reoperation: 67 (within 2 years), 473 (beyond 5 years).

Conclusions:

• The difference in early reoperation rates between oCTR and eCTR is clinically insignificant.
• eCTR demonstrates comparable long-term reoperation rates to oCTR.
• eCTR is a safe and appropriate intervention for carpal tunnel release, with benefits in reducing short-term complications.