A new study on carpal tunnel release outcomes is adding to the case for treating some orthopedic procedures outside the operating room, particularly in regions where limited orthopedic surgeon supply already pushes patients toward distant referrals for care.
The retrospective study, published in The Iowa Orthopaedic Journal, compared 165 adult patients who underwent isolated carpal tunnel release with a single surgeon from January 2022 to December 2023. Twenty-nine patients were treated in a clinic procedure suite using the wide-awake local anesthesia no tourniquet technique; the remaining 136 were treated in an ambulatory surgery center operating room, under WALANT or monitored anesthesia care.
Patients treated at the ASC spent an average of 178.36 minutes in the facility on the day of surgery, compared with 86.93 minutes for those treated in the procedure suite, a difference of 91.42 minutes. There were no statistically significant differences in validated patient-reported outcomes, including PROMIS and QuickDASH scores, or in patient demographics, between the two groups.
The study’s authors argue the findings support performing carpal tunnel release in a procedure suite “when possible,” a recommendation they tie directly to orthopedic access. Citing separate research on regional demand for orthopedic care, the authors noted that areas with low orthopedic surgeon concentration often see minor procedures like carpal tunnel release referred to distant tertiary centers, and argue office-based capacity could ease that bottleneck without requiring new OR time or additional surgeons.
The study did not evaluate cost directly, but its authors cited prior research finding operating-room-based carpal tunnel release can cost six to 29 times more than the same procedure performed in a procedure suite.
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