Background: Ultrasound-guided needle-knife therapy has emerged as a widely adopted and clinically effective intervention for carpal tunnel syndrome (CTS), demonstrating significant therapeutic outcomes in clinical practice. However, there is currently a notable lack of systematic reviews and meta-analyses evaluating the therapeutic efficacy of ultrasound-guided needle-knife therapy in the management of CTS. Systematic review and meta-analysis to assess the effectiveness of ultrasound-guided needle-knife therapy in improving CTS symptoms, wrist function, nerve conduction, ultrasonic detection index, and clinical cure rate. Methods: A PICO (Population study participants, Intervention exposure or treatment, Comparison control intervention, and Outcome key study outcomes) search strategy was used to identify randomized controlled trials applying ultrasound-guided needle-knife therapy on patients with CTS. Methodology quality and risk of bias were assessed by the Cochrane Collaboration. Outcomes assessed were pain intensity, wrist function, nerve conduction, ultrasonic detection index, clinical effective rate, and clinical cure rate. Results: Seventeen studies involving 996 patients were finally included. Test for overall effect using a random effects model showed that ultrasound-guided needle-knife therapy significant improving pain intensity (Visual Analogue Scale) (mean difference MD = 0.84, 95% confidence interval CI −1.13 to −0.55, P < .00001, I 2 = 85%), wrist function (standardized mean difference = 1.22, 95% CI: 1.59 to −0.84, P < .00001; I 2 = 80%), nerve sensory conduction (sensory conduction velocity) (MD = 3.32, 95% CI: 2.38–4.25, P < .00001; I 2 = 54%), nerve motor conduction (distal motor latency) (MD = −0.46, 95% CI: −0.64 to −0.28, P < .00001; I 2 = 80%), ultrasonic detection indicators (cross-section area) (MD = −1.88, 95% CI: −3.14 to −0.62, P =.03; I 2 = 96%), and thickness of the transverse carpal ligament (MD = −0.68, 95% CI: −1.20 to −0.15, P < .00001; I 2 = 94%), clinical effective rate (MD = 1.14, 95% CI: 1.09–1.20, P < .00001; I 2 = 46%), and clinical cure rate (MD = 1.69, 95% CI: 1.42–2.00, P < .00001; I 2 = 46%) compared with those of the CTS patients in the control group. Conclusions: This study highlights that ultrasound-guided needle-knife technology has significant effectiveness on pain, wrist function, nerve conduction, ultrasonic detection indicators (cross-section area, thickness of the transverse carpal ligament), clinical effective rate, and clinical cure rate for patients with CTS.
Tang et al. (2025) studied this question.