Department of Biostatistics, Miller Scientific, Johnson City, TN, USA.
Michigan Medicine, University of Michigan Comprehensive Hand Center, Ann Arbor, MI, USA.
Expert Rev Med Devices. 2023 May;20(5):417-425. doi: 10.1080/17434440.2023.2195549. Epub 2023 Mar 30.
The determinants of time to return to activity (RTA) and return to work (RTW) after carpal tunnel release (CTR) remain unclear.
We performed a systematic review of studies published from January 2000 to November 2022 involving patients treated with open (OCTR), mini-open (mOCTR), or endoscopic (ECTR) CTR and reporting RTA or RTW. The time to RTA and RTW were estimated using a random-effects meta-analysis model. Subgroup analysis and multivariable meta-regression explored sources of heterogeneity in outcomes.
A total of 7386 patients in 48 studies (63 groups) were included, with 24 groups (4541 patients) treated with OCTR, 16 groups (1085 patients) treated with mOCTR, and 23 groups (1760 patients) treated with ECTR. Among 15 studies (20 groups) reporting RTA, the mean was 13.1 days (95% CI, 9.9-16.3; I>99%). Shorter duration of postoperative activity restriction guidance was associated with faster RTA. Among 43 studies (58 groups) reporting RTW, the mean was 23.4 days (95% CI, 21.4-25.3; I>99%). Procedure type (mOCTR and ECTR compared to OCTR), prospective study design, and smaller proportion of patients receiving disability benefit were associated with faster RTW.
The time to RTA and RTW after CTR are highly variable and influenced by study-, patient-, and physician-specific factors.
腕管松解术后（CTR）恢复活动（RTA）和重返工作（RTW）的时间的决定因素仍不清楚。
我们对 2000 年 1 月至 2022 年 11 月期间发表的涉及接受开放式（OCTR）、微创开放式（mOCTR）或内镜式（ECTR）CTR 治疗并报告 RTA 或 RTW 的患者的研究进行了系统回顾。使用随机效应荟萃分析模型估计 RTA 和 RTW 的时间。亚组分析和多变量荟萃回归探讨了结果中异质性的来源。
共纳入 48 项研究（63 组）的 7386 例患者，其中 24 组（4541 例）接受 OCTR 治疗，16 组（1085 例）接受 mOCTR 治疗，23 组（1760 例）接受 ECTR 治疗。在 15 项（20 组）报告 RTA 的研究中，平均时间为 13.1 天（95%CI，9.9-16.3；I>99%）。术后活动限制指导的持续时间较短与 RTA 较快恢复相关。在 43 项（58 组）报告 RTW 的研究中，平均时间为 23.4 天（95%CI，21.4-25.3；I>99%）。手术类型（mOCTR 和 ECTR 与 OCTR 相比）、前瞻性研究设计和接受残疾福利的患者比例较小与 RTW 较快恢复相关。
CTR 后 RTA 和 RTW 的时间高度可变，受研究、患者和医生特定因素的影响。
