Most Carpal Tunnel Surgery Patients Have Long Term Improvement Interview with:
Isam Atroshi, MD, PhD
Department of Orthopedics
Lund University Lund, Sweden

Medical Research: What is the background for this study?

Dr. Atroshi: Although carpal tunnel release surgery is a very common operation and we know that, in the short term, the results in most patients are very good, we do not know that much about long-term outcomes. In fact, before our study there have been no reliable data about outcomes beyond 5 years and whether or not the results differ depending on type of surgery.

Medical Research: What are the main findings?

Dr. Atroshi: In our study patients with carpal tunnel syndrome who had participated in a randomized clinical trial of open versus endoscopic release were evaluated 11 to 16 years after they had the surgery. We were able to follow 124 of the 128 patients (3 had died and only 1 declined); this almost complete follow-up is unique in clinical research and a major strength of the study.

Our main findings are that the good short-term results of surgery are durable in the majority of the patients irrespective of the type of surgery whether open or endoscopic. Two-thirds of the patients can expect to continue being completely free of symptoms more than 10 years after surgery. About a third of the patients still experience some numbness or tingling in the fingers but in most of these the symptoms are only mild and do not cause functional difficulties. More than 85% are very satisfied with the results of the surgery after more than 10 years. However, up to 6% of patients who have surgery could need further surgery because of symptom recurrence.

Medical Research: What should clinicians and patients take away from your report?

Dr. Atroshi: Although nonsurgical treatment if effective would always be the preferred treatment for any condition including carpal tunnel syndrome there is unfortunately no type of nonsurgical treatment now that gives this high level of durable improvement. Therefore, patients with more severe symptoms and those who do not feel they have adequately improved after other types of treatment can choose surgery and expect very good short and long-term results (assuming the diagnosis is correct and the surgery is done appropriately).

The other point is that type of surgery does not seem to have major importance with regard to long-term results; all is needed is simple complete division of the ligament (transverse carpal ligament) and avoiding complications. In most patients no formal rehabilitation is needed after surgery; good information and advice to patients is adequate.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Atroshi: Future research should aim at finding a treatment that cures carpal tunnel syndrome without surgery, but until that is achieved surgery is a good treatment option.


Atroshi I, Hofer M, Larsson G, Ranstam J. Extended Follow-up of a Randomized Clinical Trial of Open vs Endoscopic Release Surgery for Carpal Tunnel Syndrome. JAMA.2015;314(13):1399-1401. doi:10.1001/jama.2015.12208.

Isam Atroshi, MD, PhD (2015). Most Carpal Tunnel Surgery Patients Have Long Term Improvement 

Last Updated on October 8, 2015 by Marie Benz MD FAAD