Patient-Perceived Time to Recovery After Carpal Tunnel Release

TL;DR

This study found that patients typically report full recovery from carpal tunnel surgery after about six months, which is longer than expected clinical improvements.

Contribution

The study provides new insights into patient-reported recovery timelines after carpal tunnel release surgery.

Findings

Patients report full recovery an average of 5.5 months after carpal tunnel release surgery.

Improvements in pain and function scores occurred before full recovery was reported.

Higher preoperative symptom severity was linked to not achieving full recovery within one year.

Abstract

Carpal tunnel release (CTR) is the most commonly performed hand surgery procedure, yet there is limited literature on patients’ subjective assessment of full recovery after surgery. Our primary aim was to assess the time until patients report they have achieved full recovery.

Patients who had CTR were prospectively enrolled between January 2019 and August 2020 and completed questionnaires before surgery and at standardized postoperative intervals until full recovery was reported. Study questionnaires included the Likert pain scale; the Quick Disabilities of the Arm, Shoulder and Hand Score (QuickDASH); and the Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Patients were also asked if they had fully recovered. We performed bivariate analyses to identify variables associated with time to patient-reported full recovery.

Fifty-one of 86 total patients completed the study and were included in the final cohort (59%). The mean time to patient-reported full recovery was 5.5 months. Six of 51 patients enrolled (11.8%) did not fully recover by 1 year. The mean Likert pain score, QuickDASH, BCTQ-SSS, and BCTQ-FSS considerably improved from before surgery to full recovery, and the mean differences in these four measures exceeded the minimal clinically important difference. Postoperative scores improved compared with preoperative scores for the four metrics above by 8, 11, 14, and 15 weeks, respectively. Higher preoperative Likert pain score, preoperative QuickDASH, BCTQ-SSS, and BCTQ-FSS were all associated with lack of self-reported full recovery by one year after surgery.

Patients did not report full recovery until an average of nearly 6 months after CTR, which is substantial. The reported time to full recovery was notably longer than the time to reach minimal clinically important difference for our patient-reported outcome measures. This may be useful in preoperative discussions about recovery after surgery.

Prognostic II.

Figures