Get the Facts

Carpal Tunnel Release (CTR) with ultrasound guidance has been performed for more than 24 years. The technique was first documented in a medical journal in 1997.

Introducing UltraGuideCTR™, formerly known as the SX-One MicroKnife. UltraGuideCTR is the same device with the same intended use, indications for use and clinical data regarding the safety and effectiveness of the device.

How many procedures have been performed using the UltraGuideCTR?

More than 15,000 procedures have been performed in the United States using UltraGuideCTR and real-time ultrasound guidance.

Are there clinical publications regarding carpal tunnel release using ultrasound guidance and the SX-One MicroKnife?

There are 31 peer reviewed publications regarding CTR using ultrasound guidance, including 9 publications specific to CTR with UltraGuideCTR and real-time ultrasound guidance. These studies have shown:

  • No neurovascular injuries
  • No conversions to open CTR
  • Clinical success rate of >97%

Additionally, the APEX (Assessment of the Patient EXperience) patient database tracks patient outcomes for CTR using ultrasound guidance with the UltraGuideCTR:

To date, 24 physicians have enrolled more than 400 patients into the database.

  • Intra-operative pain (Scale of 0-10. 0=No pain; 10=Worst possible pain):
    • Median 0.50 | Mean 1.48 (N=304)
  • Average time to return to normal daily activities:
    • Median 2.00 days | Mean 2.58 days (N=408)
  • Average time to return to work in any capacity:
    • Median 2.00 days | Mean 2.83 days (N=231)
  • Patients who would recommend the procedure to others (on a scale of 0-10. 0=Not at all likely; 10=Extremely likely)
    • Median 10.00 | Mean 8.92 (N=157)
Is the procedure performed in an operating room?

The majority of CTR procedures using ultrasound guidance are performed in a procedure room or office setting.

What type of anesthesia is used?

CTR with the UltraGuideCTR and ultrasound guidance is typically performed using local anesthesia.

Will I need stitches?

The small wrist incision is typically closed without stitches.

What do patients typically use to manage pain after the procedure?

Most patients only require Tylenol or Ibuprofen for pain management.

Are patients able to have surgery on both wrists the same day?

When clinically indicated, a patient can have CTR with the UltraGuideCTR and ultrasound guidance performed on both wrists on the same day. There are several published manuscripts that include outcomes data on patients who had simultaneous bilateral releases.

Is physical therapy required?

Postoperative therapy is typically not required.

When can the patient start to use their hand post procedure?

Many patients can tolerate immediate motion of their hand for rapid recovery.

Interested in learning more?


  1. Rojo-Manaute JM, Ultra-minimally invasive sonographically guided carpal tunnel release: a randomized clinical trial. J Ultrasound Med. 2016;37:e37-45.
  2. APEX patient outcomes database. Data on file.
  3. Henning PT, et. al. Minimally invasive ultrasoundguided carpal tunnel release: preliminary clinical results. J Ultrasound Med. 2018 Nov;37(11):2699-2706.
  4. Joseph EJ, et. al. Clinical Results of Ultrasound-Guided Carpal Tunnel Release Performed by a Primary Care Sports Medicine Physician. J Ultrasound Med. 2020;39: 441-52.
  5. Chappell CD, et. al. Sonographic changes in median nerve cross sectional area following microinvasive ultrasound guided carpal tunnel release. J Ultrasound Med 2020;39: 693-702.
  6. Kamel SI, et. al. Minimally Invasive Ultrasound-Guided Carpal Tunnel Release Improves Long-Term Clinical Outcomes in Carpal Tunnel Syndrome. AJR Am J Roentgenol 2020 Sep 2. doi: 10.2214/AJR.20.24383. Online ahead of print.