Performed under ultrasound guidance, the procedure involves the use of a nonthermal adjustable high-pressure stream of saline that acts as a selective debridement tool. Percutaneous tenotomy with a high-pressure saline jet (percutaneous pressured hydrotenotomy) provides a new tool for the debridement and aspiration of degenerative tissue associated with chronic tendinopathy. This approach to treating chronic tendinopathy is an example of efforts to develop effective, minimally invasive interventions for tendon disorders, which are common problems that are difficult to treat. "Thread carpal tunnel release is an eloquent and straightforward technique that offers patients quicker pain relief and recovery than conventional open carpal tunnel releases." Percutaneous ultrasound-guided hydrotenotomy "Ultrasound-assisted, minimally invasive procedures such as the thread carpal tunnel release have the potential to revolutionize how we treat some common conditions," explains Dr. Patients typically recover in about two weeks instead of the 4 to 6 weeks needed after open surgery.Īlthough published clinical outcome data associated with TCTR are limited at this time, the published data discussed by the co-authors suggest that patients treated with TCTR had symptom severity scores, function scores and satisfaction rates exceeding those associated with OCTR and ECTR in comparable studies, with no adverse events. ![]() Brault and Shin note that minor revisions in its protocol have helped reduce incomplete transection rates. Brault and Shin outline the five-step incisionless procedure. In their article and accompanying video, Drs. TCTR is designed to minimize soft tissue dissection and injury, decrease pillar pain, and accelerate recovery. The carpal tunnel ligament has been severed with an incisionless procedure. Shin, M.D., who perform TCTR at Mayo Clinic's campus in Rochester, Minnesota. Brault and orthopedic surgeon Alexander Y. In an article published in Techniques in Hand & Upper Extremity Surgery in 2021, Mayo Clinic authors provide a step-by-step overview of TCTR and review published clinical outcomes. A newer, incisionless treatment release - known as thread ultrasound-guided carpal tunnel release (TCTR) - uses an abrasive thread looped percutaneously to dissect the TCL and is performed using local anesthesia. Mayo Clinic is one of the few hand centers that offer ultrasound-guided intervention for carpal tunnel release. Endoscopic approaches are usually associated with less postoperative pain and a faster return to work, but also with increased risk of nerve injury and incomplete release. ![]() The two most common surgical interventions are open carpal tunnel release (OCTR) and endoscopic carpal tunnel release (ECTR). The goal of carpal tunnel release surgeries is to decompress the median nerve by dividing the transverse carpal ligament (TCL). The estimated cost of medical care for carpal tunnel syndrome in the United States is $2 billion a year, with a median lost work time of just under 30 days. Thread ultrasound-guided carpal tunnel releaseĬarpal tunnel syndrome is common, and an estimated 71% of patients receive surgical intervention as their primary treatment.
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