Higher Revision Rates With In Situ Decompression as Compared to Ulnar Nerve Transposition for Cubital Tunnel Syndrome: A Meta-Regression Analysis

The purpose of this study was to examine the effect of follow-up time on revision rates of in situ decompression and ulnar nerve transposition for the surgical treatment of cubital tunnel syndrome. A comprehensive literature search was performed to identify prospective and retrospective primary comp...

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Bibliographic Details
Published in:	Curēus (Palo Alto, CA) Vol. 16; no. 8; p. e68116
Main Authors:	Reichenbach, Rachel, Chartrand, Nicholas A, Stecher, Chad, Renfree, Sean P, Stickels, Michael, Hustedt, Joshua W
Format:	Journal Article
Language:	English
Published:	United States Cureus Inc 29-08-2024 Cureus
Subjects:	Bias Clinical trials Hand surgery Meta-analysis Missing data Neurosurgery Orthopedics Risk assessment Sports Medicine Surgery Surgical outcomes Canada United States > US Switzerland cubital tunnel surgery ulnar nerve transposition cubital neuropathy cubital tunnel in situ decompression systematic review and meta-analysis
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Summary:	The purpose of this study was to examine the effect of follow-up time on revision rates of in situ decompression and ulnar nerve transposition for the surgical treatment of cubital tunnel syndrome. A comprehensive literature search was performed to identify prospective and retrospective primary comparison studies assessing the revision rates of in situ decompression and ulnar nerve transposition for the treatment of cubital tunnel syndrome. Meta-regression analyses were used to assess the effect of average study follow-up on the revision rates of both cubital tunnel syndrome treatments. Modeling results were then used to estimate revision rates between decompression and transposition at increasing follow-up times. Sixteen studies including 2,225 patients were included. Average study follow-up time was a statistically significant moderator of revision rates. Model predictions show that in situ decompression operations had an increased risk for revision as compared to ulnar transposition after 48 months of follow-up. In studies with follow-up time ≥48 months, revision rates for in situ decompression (11.9%) were significantly greater than in ulnar transposition (3.2%). In situ decompression for cubital tunnel syndrome is associated with an increased risk of revision surgery as compared to ulnar nerve transposition, particularly when assessed at longer follow-up intervals. The effect of follow-up duration on revision rates demonstrates the need for additional studies to compare outcomes of these operative approaches at follow-up times ≥48 months. This study provides evidence that ulnar nerve transposition may ultimately lead to lower revision rates and demonstrates the need for prospective, randomized trials to corroborate this effect.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23
ISSN:	2168-8184 2168-8184
DOI:	10.7759/cureus.68116