Long-term follow up outcome results of Knifelight carpal tunnel release and conventional open release following a departmental randomized controlled trial. A prospective study.

BACKGROUND: Carpal tunnel syndrome is traditionally treated with open release through a long palmar incision, which leaves some patients with pillar pain and scar tenderness. The Knifelight (Stryker, Kalamazoo, MI) is an exciting new instrument that allows minimally invasive release of the transcarpal ligament without subjecting the patient to the traditional problematic open palmar incision. However, no long-term data has been published in the literature so far.

MATERIAL AND METHODS: A modified QuickDASH score questionnaire was used to assess long-term results and patient satisfaction 10 years following our department's original randomized control trial comparing open carpal tunnel release (43 patients) to carpal tunnel release using the Knifelight method (39 patients).

RESULTS: The mean modified QuickDASH score was 33.71 (SD 23.27) for the open group and 13.22 (SD 13.62) for the Knifelight group (P-value=0.0024). Patients from the open group complained of pillar pain (30%), scar tenderness (25%) and recurrence of carpal tunnel symptoms (18%). Three patients had symptoms so severe that they could not perform their jobs. In the Knifelight group there were no reports of any pain, recurrence or scar-related problems and a high level of general satisfaction was observed with this group of patients.

CONCLUSIONS: Our study results show that the minimally invasive Knifelight carpal tunnel release was associated with better clinical outcomes, less complications and overall better quality of life when compared to the conventional open carpal tunnel release.