Thread carpal tunnel release vs. minimally invasive carpal tunnel release: a systematic review and meta-analysis

Aims The goal of this systematic review and meta-analysis was to compare outcomes between ultrasound-guided thread carpal tunnel release (TCTR) and other minimally invasive surgerical techniques (MIS), for the treatment of Carpal Tunnel Syndrome.Materials/methods This systematic review was conducted according to PRISMA 2020 guidelines. Randomized controlled trials, cohort studies, and case series examining TCTR or MIS in adults (≥18 years) diagnosed with CTS were examined. Included studies must have reported pain, sensation, or functionality scores.Results/conclusion Five studies met inclusion criteria, comprising 389 patients. Mean follow-up for functionality and symptom severity scores were 8 months and 3.25 months for pain outcomes. Both TCTR and MIS demonstrated significant improvements in all outcomes. While within-group analayese suggested greater statistical robust improvement for symptom severity in the TCTR group (p < 0.01, Hedge’s G = −3.25 [−4.42, −2.08], I2 = 83.1%) compared to MIS group (p = 0.05, Hedge’s G = −2.16 [−4.32, −0.00], I2 = 99.3%), subgroup analyses did not demonstrate significant differences between TCTR and MIS for any outcomes. TCTR demonstrates comparable clinical outcomes to other minimally invasive carpal tunnel release techniques, suggesting that TCTR represents a viable minimally invasive option to the surgical management of CTS.Protocol registration The www.crd.york.ac.uk/prospero identifier is CRD42024598274.