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Early Revision Rate Following Primary Carpal Tunnel Release
Journal article   Open access   Peer reviewed

Early Revision Rate Following Primary Carpal Tunnel Release

Jack G. Graham, Kyle J. Plusch, Bryan A. Hozack, Asif M. Ilyas and Jonas L. Matzon
Journal of hand surgery global online, v 5(3), pp 277-283
01 May 2023
DOI: https://doi.org/10.1016/j.jhsg.2023.01.010
PMID: 37323965
url
https://doi.org/10.1016/j.jhsg.2023.01.010View
Published, Version of Record (VoR) Open

Abstract

Carpal tunnel release Carpal tunnel syndrome Revision carpal tunnel release
The published revision rates after carpal tunnel release (CTR) vary from 0.3% to 7%. The explanation for this variation may not be fully apparent. The purpose of this study was to determine the rate of surgical revision within 1–5 years following primary CTR at a single academic institution, compare it with rates reported in the literature, and attempt to provide explanations for these differences. We identified all patients who underwent primary CTR at a single orthopedic practice by 18 fellowship-trained orthopedic hand surgeons from October 1, 2015, through October 1, 2020, using a combination of Current Procedural Terminology (CPT) and International Classification of Diseases (ICD), 10th Revision, codes. Patients who underwent CTR because of a diagnosis other than primary carpal tunnel syndrome were excluded. Patients who required revision CTR were identified using a practice-wide database query using a combination of CPT and ICD-10 codes. Operative reports and outpatient clinic notes were reviewed to determine the cause of revision. Data on patient demographics, surgical technique (open vs single-portal endoscopic), and medical comorbidities were collected. A total of 11,847 primary CTR procedures were performed during the 5-year period on 9,310 patients. We found 24 revision CTR procedures among 23 patients, resulting in a revision rate of 0.2%. Of 9,422 open primary CTRs performed, 22 cases (0.23%) went on to undergo revision. Endoscopic CTR was performed in 2,425 cases, with 2 cases (0.08%) ultimately undergoing revision. The average length of time from primary CTR to revision was 436 days (range, 11–1,647 days). We noted a substantially lower rate of revision CTR within 1–5 years of primary release (0.2%) in our practice than that noted in previously published studies, although we accept that this does not account for out-of-area migration. There was no significant difference in the revision rates between open and single-portal endoscopic primary CTR. Therapeutic III.

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