Evidence map›Paper›PMID 40699057›Full record

SynthesisBJS open2025

Time to recovery following open and endoscopic carpal tunnel decompression: meta-analysis.

Olivia J Hartrick, Rebecca K Turner, Alexander Freethy, Chetan Khatri, Lauren Chong, Ryckie G Wade, Justin C R Wormald, Akira Wiberg, Jeremy N Rodrigues, Conrad Harrison

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BJS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Olivia J HartrickDepartment of Plastic, Reconstructive, and Hand Surgery, Stoke Mandeville Hospital, Aylesbury, UK.
Rebecca K TurnerUK Centre for Ecology and Hydrology, Durrell Institute of Conservation and Ecology, University of Kent, Canterbury, UK.
Alexander FreethyDepartment of Plastic Surgery, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK.
Chetan KhatriTrauma and Orthopaedic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Lauren ChongSchool of Medicine and Biomedical Sciences, University of Oxford, Oxford, UK.
Ryckie G WadeLeeds Institute for Medical Research, University of Leeds, Leeds, UK.
Justin C R WormaldNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.ORCID 0000-0001-6197-4093
Akira WibergNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.ORCID 0000-0003-4944-123X
Jeremy N RodriguesClinical Trials Unit, Warwick Medical School, Warwick, UK.
Conrad HarrisonNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.

Funding

ARIES DTP NE/S007334/1National Institute for Health Research NIHR CL-2021-02-002Natural Environment Research Council
6 · The paper itself

Abstract

backgroundCarpal tunnel release (CTR) can be performed using either an open or endoscopic approach. The patient recovery trajectories remain poorly understood. This study aimed to define and compare patient-reported recovery following unilateral open and endoscopic CTR.

methodsA PRISMA-compliant, preregistered (CRD42023427718) systematic review was conducted, searching PubMed, Embase, and Cochrane databases on 4 July 2023 and 21 August 2024. Studies were included if they reported recovery data (patient-reported outcome measures (PROMs)) at predefined time points for adults undergoing unilateral CTR. Boston Carpal Tunnel Questionnaire and Quick Disabilities of Arm, Shoulder, and Hand scores were extracted. Standardized mean change (SMC) scores from baseline were pooled using random-effects meta-analysis. An innovative modification of the National Institutes of Health quality assessment tools was used to evaluate the risk of bias.

resultsIn all, 49 studies were included (4546 participants included in the analysis; 3137 open CTR, 1409 endoscopic CTR). Both approaches improved PROM scores over 12 weeks, with early (4-week) outcomes strongly correlating (>0.89) with later (12-week) outcomes. Symptoms continued improving up to 104 weeks. At 1 week, open CTR showed symptomatic deterioration (SMC 10.29; 95% confidence interval (c.i.) 6.35 and 14.21 respectively), comparatively, endoscopic CTR demonstrated an improvement (SMC -2.83; 95% c.i. -7.80 and 2.14 respectively). By 2 weeks, symptom severity remained slightly worse in open CTR, but confidence intervals overlapped from week 3 and thereafter open CTR showed greater symptomatic improvement. Most studies had a high risk of bias and measured outcomes too infrequently for a granular comparison.

conclusionsPatient-reported recovery trajectories for CTR can inform patient counselling and future research. Endoscopic CTR may result in fewer symptoms in the first 2 weeks, but open CTR may offer comparable or potentially greater improvement thereafter. Future trials with high-frequency PROM capture should prioritize early (first 3 weeks) and long-term (≥24 weeks) outcomes.

Indexed as

Carpal Tunnel SyndromeDecompression, SurgicalEndoscopyHumansPatient Reported Outcome MeasuresRecovery of FunctionTime FactorsTreatment Outcomeorthopaedicsplastic surgery

Identifiers

PMID40699057
PMCPMC12284922

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.