Please cite this article in press as: Lecoq B, et al. Ultrasound-assisted surgical release of carpal tunnel syndrome: Results of a pilot open- label uncontrolled trial conducted outside the operating theatre. Joint Bone Spine (2015), http://dx.doi.org/10.1016/j.jbspin.2015.01.024 ARTICLE IN PRESS G Model BONSOI-4150; No. of Pages 4 Joint Bone Spine xxx (2015) xxx–xxx Available online at ScienceDirect www.sciencedirect.com Original article Ultrasound-assisted surgical release of carpal tunnel syndrome: Results of a pilot open-label uncontrolled trial conducted outside the operating theatre  Bertrand Lecoq a,∗,1 , Nathalie Hanouz b , Rémy Morello c , Pierre-Yves Jean-Jacques a , Jean-Jacques Dutheil c , Christophe Hulet b , Christian Marcelli a a Department of Rheumatology, Caen University Hospital, avenue de la Côte de Nacre, BP 95182, 14033 Caen cedex 9, France b Department of Orthopaedics, Caen University Hospital, avenue de la Côte de Nacre, BP 95182, 14033 Caen cedex 9, France c Department of Biostatistics, Caen University Hospital, avenue de la Côte de Nacre, BP 95182, 14033 Caen cedex 9, France a r t i c l e i n f o Article history: Accepted 29 January 2015 Available online xxx Keywords: Carpal tunnel Sonography Ultrasound Surgery Surgical release a b s t r a c t Objective: To confirm the feasibility of ultrasound-assisted surgical release of carpal tunnel syndrome in the interventional radiology room. Materials and methods: Study involving 39 patients suffering from carpal tunnel syndrome confirmed by electromyogram and unresponsive to medical treatment. The patients were recruited via orthopedic surgery and rheumatology consultations and were operated on in the interventional radiology room under local anesthesia. A single approach was used, at the wrist flexion crease. Patients were monitored over a 90-day period. This is a descriptive open-label uncontrolled study. Results: Fifteen men and 24 women, aged between 21 and 86 years, were included, 23 of whom were in work. The mean surgical procedure time was of 19.0 ± 4.6 minutes; the mean room occupancy time was of 38.0 ± 8.1 minutes and the mean volume of local anesthetic used was of 14.7 ± 2.3 cc. The score for pain, formication and discomfort experienced in the hand was significantly reduced by day 15 (49.1 ± 21.1 vs. 23.5 ± 19.5; P < 0.001). Eight patients continued to present with paresthesia on day15 and only 3 by day 30. Four patients had returned to work by day 15, 10 patients considered that they could have resumed work within an average of 9.9 ± 4.9 days after the procedure. Twenty-five patients estimated that they could resume their daily activities within a mean period of 7 ± 3.9 days. No postoperative complications related to the procedure were observed. Conclusion: According to the results of this study, ultrasound-assisted surgical release of carpal tunnel syndrome performed outside the operating theatre seems to be effective and well-tolerated. © 2015 Société franc ¸ aise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved. In the United States, carpal tunnel syndrome (CTS) affects 1% of the general population and 5% of the active population [1]. Carpal tunnel surgery is the most frequent of hand and wrist surgical procedures in the USA, with more than 500,000 surgical procedures per year [2]. The direct costs induced by this disease in the US are of 1 billion dollars per year [1]. CTS is responsible for a significant loss of working days (National Center for Health  This study was promoted by the Caen University Hospital, Caen, France. ∗ Corresponding author. Tel.: +33 2 31 06 47 55; fax: +33 2 31 06 49 63. E-mail address: dr.blecoq@orange.fr (B. Lecoq). 1 The corresponding author certifies that all authors approved the entirety of the submitted material and contributed actively to the study. Statistics). According to the Bureau of Labor and Statistics and the National Institute for Occupational Safety and Health-NIOSH, CTS affects 8 million Americans and in half of these cases, the CTS is linked to professional activity. Twenty-five percent of persons working on computer keyboards suffer from CTS. Only 23% of patients operated for CTS are able to resume their previous work. Carpal tunnel syndrome is a disease caused by compression of the median nerve. The most frequently observed symptom is a sen- sation of formication (or acroparesthesia) in the first 3 to 4 fingers, generally when sleeping or waking up. Other symptoms, such as numbness of the fingers or clumsiness, may also be reported. When a surgical indication is established, two surgical approaches are currently available to treat carpal tunnel syndrome: http://dx.doi.org/10.1016/j.jbspin.2015.01.024 1297-319X/© 2015 Société franc ¸ aise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.