The American Academy of Orthopaedic Surgeons (AAOS) has recently updated the Clinical Practice Guideline (CPG) for the Management of Carpal Tunnel Syndrome (CTS). This new guideline focuses on evidence-based recommendations that emphasize the long-term benefits of CTS treatment for adult patients 18 years and older. The goal is to help orthopaedic surgeons, physicians, and patients determine the best treatment approach for CTS.
According to Dr. Lauren Shapiro, the co-chair of the guideline development group, the update was necessary to shift the focus towards cost-effective, high-quality, and patient-centered care. The updated guideline provides clear recommendations to optimize patient outcomes while minimizing unnecessary interventions.
CTS is a common compressive neuropathy that affects the upper extremity, leading to symptoms such as pain, numbness, and tingling in the hand and forearm. The burden of CTS in the Medicare patient population in the United States alone amounts to billions of dollars annually.
The new guideline emphasizes the use of the CTS-6 evaluation tool for diagnosis, which has shown to be effective in diagnosing CTS without the need for costly and painful tests like ultrasonography or nerve conduction velocity tests. The guideline also supports both mini-open and endoscopic carpal tunnel release as effective long-term treatment options for CTS.
In terms of postoperative care, the guideline recommends against routine postoperative supervised therapy after carpal tunnel release. Instead, it suggests the use of non-steroidal anti-inflammatory drugs and/or acetaminophen for pain management. The guideline also debunks the association between high keyboard use and CTS.
Dr. Robin Kamal, the co-chair of the guideline development group, highlights that the recommendations in the CPG are intended for shared decision-making between patients and physicians, rather than insurer determinations. The guideline is a collaborative effort between various medical associations and serves as a reference tool for healthcare professionals managing patients with CTS symptoms.
Overall, the updated Clinical Practice Guideline for the Management of Carpal Tunnel Syndrome provides valuable insights for physicians and orthopaedic surgeons in treating CTS patients effectively. The full guideline can be accessed through the AAOS’ OrthoGuidelines website for further information.