J Hand Surg Am. 2025 Nov 3:S0363-5023(25)00563-5. doi: 10.1016/j.jhsa.2025.09.018. Online ahead of print.
ABSTRACT
PURPOSE: The purpose of this study was to investigate whether early hematopoietic stem cell transplantation (HSCT) in infants with Hurler syndrome affects the timing of carpal tunnel syndrome (CTS) surgery.
METHODS: Forty-seven patients with Hurler syndrome who underwent allogeneic HSCT at the University of Minnesota between 2005 and 2020 at early (3-13 months), middle (13-18 months), and late (18-35 months) age tertiles were followed for at least 4 years to determine (1) the timing of CTS diagnosis based on electrodiagnostic testing and (2) the timing of surgical intervention for CTS. A cumulative incidence function was used to estimate the time to surgery.
RESULTS: Based on electrodiagnostic testing, the risk of CTS diagnosis after HSCT increased as age at HSCT increased from 3 to 15 months old. Surgery was also performed later in patients who were transplanted at younger ages, occurring at a median of 7.3 years after HSCT for the early tertile of transplant ages versus 3.5 years after HSCT for the middle and late tertiles of transplant ages.
CONCLUSIONS: Early HSCT in patients with Hurler syndrome may delay the need for CTS surgery.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
PMID:41182212 | DOI:10.1016/j.jhsa.2025.09.018