Endoscopic Carpal Tunnel Syndrome Release: A Bibliometric Analysis of the Top 100 Most Cited Articles

Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, and endoscopic carpal tunnel release (ECTR) has emerged as a popular minimally invasive surgical option. This study aimed to perform a bibliometric analysis of the 100 most-cited articles on ECTR to evaluate research trends, scholarly impact, and gaps in the literature. Methods: A comprehensive search of the Web of Science Core Collection was conducted on February 22, 2025, using the keyword “endoscopic carpal tunnel syndrome” to identify the 100 most cited articles on ECTR. Results: A total of 100 top-cited articles on ECTR were analyzed. The most cited article had 684 citations. Most of the studies were published between 1990 and 2010 (76.0%), with a peak from 2000 to 2009 (40.0%). The United States (US) contributed 45.0% of the articles, and the Journal of Hand Surgery-American Volume published the most (15.0%). The corresponding authors were predominantly male (98.0%) and affiliated with orthopedic (46.0%) or plastic surgery (24.0%) departments. Most articles were single-institution studies (84.0%). The retrospective cohort (25.0%) was the most common. Patient-specific surgical outcomes (57.0%) dominated, with outcome tools such as the Functional Status Score (24.4%) and Boston Carpal Tunnel Questionnaire (20.0%) frequently used. Median citation count was 53.5 (IQR 40.0–118.0), and 64.0% provided Level 1 or 2 evidence. The leading contributors included Atroshi and Vasiliadis. Conclusion: This bibliometric analysis revealed that the ECTR literature is predominantly driven by US-based orthopedic authors. Despite a strong focus on patient outcomes, gaps remain in innovation, global representation, and long-term follow-up data.