Revision Rate after Open vs Endoscopic Cubital Tunnel Release: A Retrospective Review
Emma P Dwyer, MD1; Elizabeth C Truelove, MD2; Pranav Krishnan, BS1; Megan Anne Conti Mica, MD3
1University of Chicago, Chicago, IL; 2University of Pittsburgh Medical Center, Pittsburgh, PA; 3Orthopedics, University of Chicago, Chicago, IL
Introduction: While open cubital tunnel release (OCuTR) is currently the standard for surgical treatment, endoscopic decompression has gained in popularity due to its minimally invasive nature and potentially improved outcomes postoperatively. The purpose of this study is to evaluate the reoperation rates after open versus endoscopic cubital tunnel release.
Materials & Methods: A retrospective chart review was preformed of all patients who underwent an open cubital tunnel release (OCuTR) or endoscopic cubital tunnel release (ECuTR) over a five-year period. Patients were excluded if they had a potentially confounding condition, such as a distal humerus fracture or traumatic nerve injury. Preoperative patient characteristics were noted, including the modified McGowan score and duration of symptoms. Postoperative findings included the occurrence of a complication, if revision surgery was performed, and the Wilson and Krout outcome values. For the statistical comparison between OCuTR and ECuTR groups, we used the Chi-Square Test for categorical variables and the Mann-Whitney U-Test for continuous variables. Significance was defined as a p-value < 0.05 with confidence interval of 95%.
Results: One hundred and twenty-two patients were identified as undergoing CuTR from 2015-2020 with 79 patients meeting criteria. There were 31 men (39%) with a mean age of 52 years. Thirty-one patients (39%) received OCuTR while 48 patients (61%) received ECuTR. The duration of symptoms prior to surgery was significantly different between the two groups with a mean of 12.5 months (standard deviation (SD) 22.7) for OCuTR and 35.6 months (SD 47.9) for ECuTR (p-value=0.016). There was no significant difference in modified McGowan scores (p-value=0.14). Average follow-up for all patients was 4.6 months. The overall reoperation rate among the study population was 8.8% (7 of 79) with no significant difference in the revision rates between the two groups (OCuTR: 2 (6.4%); ECuTR: 5 (10.4%); p-value= 0.54). The overall complication rate among the study population was 21.5% (17 of 79) with no significant difference between the two groups (OCuTR: 8 (25.8%); ECuTR: 9 (18.75%); p-value=0.46). Modified McGowan scores and duration of preoperative symptoms had no correlation with the rate of revision surgery or postsurgical complications.
Conclusion: There is no significant difference in surgical revision rates or postoperative complication rates in OCuTR compared to ECuTR.
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