Longitudinal Changes in Patient-Reported Outcomes Following Carpal Tunnel Release: A Retrospective Cohort Study.

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Hand Surgery
• Rehabilitation Medicine

Background:

• Carpal tunnel syndrome (CTS) is a prevalent condition often treated with carpal tunnel release (CTR).
• The postoperative recovery timeline following CTR is not well-defined, impacting patient expectations and clinical management.
• Understanding the timing of meaningful improvement and recovery plateau is crucial for effective patient counseling.

Purpose of the Study:

• To determine the time to achieve clinically meaningful improvement in patient-reported outcome measurements (PROMs) after CTR for CTS.
• To identify the timing for reaching a plateau in PROMs following CTR.
• To compare the recovery trends observed in PROMs with those from nerve conduction studies.

Main Methods:

• Retrospective study of 82 patients undergoing CTR for CTS.
• Collection of PROMs (QuickDASH, BCTQ) at baseline and 3, 6, 9, 12, 18, and 24 months post-surgery.
• Nerve conduction studies performed at 6, 9, 12, 18, and 24 months to assess electrophysiological recovery.

Main Results:

• PROMs demonstrated improvement exceeding minimum clinically important differences between 6-9 months after CTR.
• Patient-reported outcomes reached a plateau approximately 12-14 months post-surgery.
• Nerve conduction studies showed a delayed plateau in distal latency for sensory and compound muscle action potentials around 18 months.

Conclusions:

• Clinical recovery, as measured by PROMs, is evident by 6-9 months and plateaus by 12-14 months after CTR.
• Electrophysiological recovery, assessed by nerve conduction studies, lags behind clinical improvement, plateauing later at approximately 18 months.
• Postoperative electrodiagnostic testing may not be beneficial due to the delayed electrophysiological recovery compared to clinical outcomes, aiding in patient counseling.