Real-World Outcomes of Ultrasound-Guided Carpal Tunnel Release in 1,082 Hands: 6-Month Results From the MISSION Registry

Purpose To report 6-month outcomes from the MISSION registry in patients treated with ultrasound-guided carpal tunnel release (UGCTR) in routine clinical practice. Methods MISSION is a prospective multicenter observational registry of patients with carpal tunnel syndrome treated with UGCTR after failed nonsurgical management. Outcomes included time to return to normal activities and work, Boston Carpal Tunnel Questionnaire Symptom Severity Scale and Functional Status Scale, pain severity (0–10 scale), health-related quality of life measured with the EuroQoL 5-Dimension 5-Level, patient satisfaction, adverse events, and revision procedures through 6 months of follow-up. Results A total of 887 patients (1,082 hands) underwent UGCTR at 22 sites in the United States. Wide-awake local anesthesia no tourniquet was used in 82.1% of procedures, 22.0% of patients were treated with simultaneous bilateral release, and the mean incision length was 5 ± 1 mm. The median time to resume normal activities was 3 days (interquartile range 1–5 days), and the time to return to work was 4 days (interquartile range 2–7 days). Follow-up was available on over 98% of patients at 6 months. All patient-reported outcomes significantly improved over this period, with mean changes of −1.66 points (95% confidence interval [95% CI], −1.69 to −1.62) on the Boston Carpal Tunnel Questionnaire-Symptom Severity Scale, −1.06 points (95% CI, −1.10 to −1.03) on the Boston Carpal Tunnel Questionnaire-Functional Status Scale , −3.9 points (95% CI, −4.1 to −3.8) for pain severity, and 0.15 points (95% CI, 0.14–0.16) on the EuroQoL 5-Dimension 5-Level. Among all treated hands, patient satisfaction was 89.9% at 6 months. No serious adverse events occurred and the reoperation rate was 0.1%. Clinical outcomes were similar for unilateral and simultaneous bilateral procedures. Conclusions In this real-world cohort, UGCTR was associated with short recovery times, substantial improvement in symptoms and function, high patient satisfaction, low complication rates, and a reoperation rate of 0.1% through 6 months. Type of study/level of evidence Therapeutic III.