Crowd-sourcing public perceptions of endoscopic versus open carpal tunnel release

Background Primary surgical management of carpal tunnel syndrome (CTS) is performed using an open or endoscopic technique. This study aimed to gather data on public perception of the cost, recovery, and associated potential complications of these two techniques. Methods Participants were recruited using Amazon Mechanical Turk (MTurk (c)) and presented with a series of scenarios regarding open or endoscopic carpal tunnel release. Scenarios involved cost differential, duration of recovery, surgical technique, and potential complications following surgery. Participants were asked to provide a utility score between 0 and 100, with 0 representing the equivalent of death and 100 representing the participant feeling they were in perfect health. Results A total of 410 participants completed the survey. Participant demographic data included average age of 37.78 (range 18-78), 62.4% female participants, 83.4% right-handed, 78.7% worked full- or part-time jobs, and 56.5% would be unable to complete their work with one hand immobilized. Participants favored endoscopic versus open surgery in both dominant and non-dominant hands (p < 0.0001). However, they viewed temporary paresthesia from endoscopic surgery less favorably to significant surgical site tenderness in open carpal tunnel release in both dominant and non-dominant hands (p < 0.0001). Conclusions When considering cost, recovery duration, and technical ability required by the surgeon, patients prefer endoscopic carpal tunnel release over open surgery in both dominant and non-dominant hands. Subgroup analysis suggests that attitudes towards endoscopic versus open carpal tunnel release are not influenced by ability to perform work with the hand immobilized or income level. Level of evidence: Not ratable.