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Open Compared With 2-Portal Endoscopic Carpal Tunnel Release: A 5-Year Follow-Up of a Randomized Controlled Trial

Atroshi, Isam, MD, PhD ; Hofer, Manfred, PT ; Larsson, Gert-Uno, MD ; Ornstein, Ewald, MD, PhD ; Johnsson, Ragnar, MD, PhD ; Ranstam, Jonas, PhD

The Journal of hand surgery (American ed.), 2009-02, Vol.34 (2), p.266-272 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Open Compared With 2-Portal Endoscopic Carpal Tunnel Release: A 5-Year Follow-Up of a Randomized Controlled Trial
Autor: Atroshi, Isam, MD, PhD ; Hofer, Manfred, PT ; Larsson, Gert-Uno, MD ; Ornstein, Ewald, MD, PhD ; Johnsson, Ragnar, MD, PhD ; Ranstam, Jonas, PhD
Assuntos: Adult ; Biological and medical sciences ; Carpal tunnel syndrome ; Carpal Tunnel Syndrome - surgery ; Clinical Medicine ; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction ; Diseases of the osteoarticular system ; endoscopic ; Endoscopy - methods ; Female ; Follow-Up Studies ; Humans ; Klinisk medicin ; Male ; Medical and Health Sciences ; Medical sciences ; Medicin och hälsovetenskap ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Orthopedics ; Ortopedi ; Pain Measurement ; Patient Satisfaction ; randomized trial ; Reoperation ; Severity of Illness Index ; surgery
É parte de: The Journal of hand surgery (American ed.), 2009-02, Vol.34 (2), p.266-272
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-News-1
ObjectType-Feature-3
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Descrição: Purpose The purpose of this investigation was to extend the previously reported short-term randomized trial of open and endoscopic carpal tunnel release in patients with carpal tunnel syndrome (CTS) to compare outcomes 5 years after surgery. Methods In a single-center randomized controlled trial, 128 patients (25 to 60 years) with clinically diagnosed and electrophysiologically confirmed idiopathic CTS were randomized immediately before surgery to open or 2-portal endoscopic release. The outcome measures included the validated CTS questionnaire's symptom severity and functional status scales (scored from 1 to 5) completed at baseline and 1 year postoperatively. At the extended follow-up of the trial 5 years after surgery, 2 patients had died and the other 126 participants (63 patients in each group) completed the CTS questionnaire. Results At the 5-year follow-up no difference between the groups was found in the CTS symptom severity score. The mean (SD) score in the open group was 1.42 (0.7) and in the endoscopic group was 1.45 (0.7), and the mean difference in score change from baseline was 0.03 (95% confidence interval, −0.21 to 0.27). Between 1 year and 5 years postoperatively, the CTS symptom severity score had deteriorated by at least 0.4 point in 9 patients in the open group and in 10 patients in the endoscopic group. The mean (SD) CTS functional status score was 1.29 (0.5) in the open group and 1.30 (0.5) in the endoscopic group. At 5 years, 11 patients in the open group and 10 patients in the endoscopic group reported persistent pain in the scar or proximal palm. Three patients in each group had repeat surgery on the operated hand because of persistent or recurrent symptoms. Conclusions The improvements in symptoms of CTS and hand-related disability 5 years after open and 2-portal endoscopic carpal tunnel release were equivalent. Type of study/level of evidence Therapeutic I.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Open Compared With 2-Portal Endoscopic Carpal Tunnel Release: A 5-Year Follow-Up of a Randomized Controlled Trial

Atroshi, Isam, MD, PhD ; Hofer, Manfred, PT ; Larsson, Gert-Uno, MD ; Ornstein, Ewald, MD, PhD ; Johnsson, Ragnar, MD, PhD ; Ranstam, Jonas, PhD

New York, NY: Elsevier Inc

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