Five-year follow-up of carpal tunnel release in patients over age 65.

PURPOSE

In 2005, a prospective clinical trial with a 6-month follow-up demonstrated the efficacy of carpal tunnel release in patients 65 years and older and showed that age is not a contraindication to surgery. The purpose of this study was to determine whether there was any further improvement, maintenance of results, or recurrence of carpal tunnel symptoms 5 years after surgery.

METHODS

We contacted all 66 patients (with a total of 92 hands involved) from the original study to be enrolled for re-evaluation. Of the original cohort, 12 were unavailable because of death or severe neurologic impairment. Of the remaining 54 patients, 19 agreed to participate in this follow-up study of their 29 hands. For the 5-year follow-up, patients underwent a repeat history and physical examination with particular emphasis on the status of their hands over the past 5 years. The Michigan Hand Outcome Questionnaire was again used to determine overall hand function, activities of daily living, work performance, pain, aesthetics, and satisfaction with hand function.

RESULTS

The mean age of patients available for 5-year follow-up was 78 +/- 3 years. The patients maintained their symptom improvement, demonstrating no significant difference between the 6-month and 5-year follow-up data; their physical findings, except for grip strength, were likewise unchanged. The patients also retained their improved 2-point discrimination. Scar tenderness decreased over the 5 years. The Michigan Hand Outcome Questionnaire confirmed the fact that initial postoperative improvement in all parameters persisted at least 5 years. One patient underwent repeat carpal tunnel release of 1 hand for recurrent symptoms. Overall, 94% of patients were either very or completely satisfied with their results.

CONCLUSIONS

Patients who were 65 years of age or older at the time of surgery maintained their clinical improvement for at least 5 years after surgery.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.