{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:38:59Z","timestamp":1787027939387,"version":"build-2736575974"},"reference-count":41,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T00:00:00Z","timestamp":1783209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Persistent and recurrent symptoms after carpal tunnel release remain challenging, and non-surgical options for post-surgical carpal tunnel syndrome (CTS) are poorly defined. This study evaluated 6-month treatment success after ultrasound-guided 5% dextrose in water (D5W) hydrodissection in persistent or recurrent post-surgical CTS and compared outcomes between subgroups. Methods: In this prospective single-center interventional cohort study, 100 patients with post-surgical CTS were enrolled: 50 with persistent disease and 50 with recurrent disease. All underwent 1\u20134 treatments with ultrasound-guided D5W hydrodissection using a standardized protocol. Treatment success at 6 months was defined as Patient Global Impression of Change (PGIC) scores of 6\u20137 together with clinically meaningful improvement in at least two of three domains: \u226530% reduction in 0\u201310 VAS pain, \u22650.8-point reduction in BCTQ-SSS, and \u22650.5-point reduction in BCTQ-FSS. Secondary outcomes included 12-month durability; longitudinal clinical, ultrasonographic, and electrodiagnostic changes; predictors of treatment success; treatment exposure; and safety. Results: Treatment success at 6 months occurred in 58 of 100 patients (58.0%) and was more frequent in recurrent than persistent CTS (70.0% vs. 46.0%, p = 0.015). At 12 months, treatment success persisted in 52.0% of the cohort (64.0% vs. 40.0%, p = 0.017). Clinical and ultrasonographic outcomes improved significantly over time, with greater improvement in recurrent CTS. Electrodiagnostic improvement was more modest. Recurrent CTS independently predicted success (adjusted OR 2.58, 95% CI 1.10\u20136.03), whereas severe electrodiagnostic involvement and greater baseline median nerve cross-sectional area were associated with lower odds of success. No serious treatment-related adverse events occurred. Conclusions: Ultrasound-guided D5W hydrodissection was associated with meaningful improvement in post-surgical CTS, particularly recurrent disease.<\/jats:p>","DOI":"10.3390\/diagnostics16132106","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T08:05:38Z","timestamp":1783325138000},"page":"2106","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultrasound-Guided 5% Dextrose Hydrodissection Procedures for Persistent and Recurrent Post-Surgical Carpal Tunnel Syndrome: A Prospective Single-Center Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9043-7585","authenticated-orcid":false,"given":"Marius Nicolae","family":"Popescu","sequence":"first","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Clinic of Physical and Rehabilitation Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0891-4775","authenticated-orcid":false,"given":"Claudiu","family":"C\u0103pe\u021b","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Clinic of Physical and Rehabilitation Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6665-6744","authenticated-orcid":false,"given":"Simona Elena","family":"S\u0103vulescu","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Clinic of Physical and Rehabilitation Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4632-576X","authenticated-orcid":false,"given":"Cristina","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Oncologic Dermatology, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9379-4580","authenticated-orcid":false,"given":"Mihai","family":"Berteanu","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Clinic of Physical and Rehabilitation Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2434","DOI":"10.1001\/jama.2022.8481","article-title":"Common Hand Conditions: A Review","volume":"327","author":"Currie","year":"2022","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S1474-4422(22)00432-X","article-title":"Carpal Tunnel Syndrome: Updated Evidence and New Questions","volume":"22","author":"Padua","year":"2023","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"551","DOI":"10.5435\/JAAOS-D-18-00004","article-title":"Management of Recalcitrant Carpal Tunnel Syndrome","volume":"27","author":"Lauder","year":"2019","journal-title":"J. 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