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Review
. 2024 Aug 29;16(8):e68116.
doi: 10.7759/cureus.68116. eCollection 2024 Aug.

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

Rachel Reichenbach  1 , Nicholas A Chartrand  1 , Chad Stecher  2 , Sean P Renfree  3 , Michael Stickels  1 , Joshua W Hustedt  1
Affiliations
Review

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

Rachel Reichenbach et al. Cureus. .

Abstract

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.

Keywords: cubital neuropathy; cubital tunnel; cubital tunnel surgery; in situ decompression; systematic review and meta-analysis; ulnar nerve transposition.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flowchart.
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Figure 2
Figure 2. Forest plot representing the log odds ratio of each study included in the meta-analysis, sorted by average follow-up time.
Figure 3
Figure 3. Bubble plot of revision rates by months of follow-up, with the estimated linear prediction and 95% confidence interval.
See this image and copyright information in PMC

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