Human Amniotic Membrane Wrapping of the Ulnar Nerve During Cubital Tunnel Surgery Reduces Recurrence of Symptoms

Document Type : RESEARCH PAPER


1 Kaiser Permanente Southern California

2 University of Southern California

3 Kaiser Permanente Southern California Research & Evaluation Department


Background: Compare recurrence rate of paresthesias in patients undergoing primary cubital tunnel surgery in those with and without wrapping of the ulnar nerve with human amniotic membrane (HAM).
Methods: This was a retrospective investigation of patients undergoing primary cubital tunnel surgery with a minimum 90-day follow-up. Patients were excluded if the nerve was wrapped using another material, associated traumatic injury, simultaneous Guyon’s canal release, or revision procedures. Failure was defined as those patients who experienced initial complete resolution of symptoms (paresthesias) but then developed recurrence of paresthesias.
Results: 57 controls (CON) and 21 treated with HAM met our inclusion criteria. There was a difference in mean age of CON (48.4 ± 13.5 years) and HAM (30.6 ± 15) (P< 0.0001). There was no difference in gender mix (P=0.4), severity of symptoms (P=0.13), and length of follow up (P=0.084). None of 21 (0%) treated with HAM developed recurrence of symptoms compared to 11 of 57 (19.3%) (P=0.03) (CON). Using multivariate regression model adjusted for age and procedure type, CON were 24.4 (95% CI=1.26-500, p=0.0348) times higher risk than HAM of developing recurrence of symptoms.
Conclusion: HAM wrapping used in primary cubital tunnel surgery significantly reduced recurrence rates of paresthesias. Further prospective studies with randomization should be carried out to better understand the role HAM can play in cubital tunnel surgery


Articles in Press, Accepted Manuscript
Available Online from 25 December 2021
  • Receive Date: 06 October 2021
  • Revise Date: 27 November 2021
  • Accept Date: 13 December 2021
  • First Publish Date: 25 December 2021