Open vs. Endoscopic Carpal Tunnel Release Surgery: A 10-year Analysis of United States Utilization

Objectives Surgical treatment of carpal tunnel syndrome (CTS) can be performed through an open or endoscopic approach. Carpal tunnel release (CTR) performed endoscopically has been offered as a less invasive alternative to an open release. This study assesses the past 10-year trends in utilization and geographic differences of both approaches across the United States (U.S.). The study hypothesis is that the utilization of endoscopic CTR has been increasing. Methods A retrospective database analysis was conducted using the TriNetX U.S. Collaborative Network for patients with CTS who underwent open or endoscopic CTR surgery between 2014 and 2023. Information on patient characteristics, rates of CTR, and geographic location were collected and reported. Results A total of 215,115 patients who had undergone CTR surgery were identified. Age, sex, demographics, and BMI did not differ between the open and endoscopic groups. Overall, open and endoscopic CTR rates have increased in the past decade, with open being the most common approach. The region with the greatest usage of endoscopic surgery in the U.S. was the South (32%), followed by the Northeast, West, and Midwest. Conclusions Over the last decade, the rates of CTR have been increasing for both open and endoscopic techniques. Although open remains the most common approach, endoscopic CTR has gained popularity over the last decade. Regionally, the South utilized the endoscopic approach at greater rates than other regions in the U.S.