Researchers at the University of Washington, Seattle, found that patients who underwent targeted nerve implantation (TNI) experienced reduced amputation-related neuroma pain. TNI reduces neuroma-related pain “by providing a distal target for regenerating axons,” according to the study, published in the April online edition of the journal Clinical Orthopaedics and Related Research. It is a procedure whereby the proximal amputated nerve stump is implanted “onto a surgically denervated portion of a nearby muscle at a secondary motor point so that regenerating axons might arborize into the intramuscular motor nerve branches rather than form a neuroma.”
The researchers retrospectively reviewed two groups of patients treated by one surgeon: 12 patients who underwent primary TNI for neuroma prevention at the time of acute amputation, and 23 patients with established neuromas who had an existing neuroma excision. The minimum follow-up palpation was eight months post-procedure for the primary TNI group (mean was 22 months; range was eight-60 months), and four months post-procedure for the secondary TNI group (mean was 22 months; range was four-72 months). Ninety-two percent of patients who underwent TNI for neuroma prevention at the time of amputation, and 87 percent who underwent TNI to treat an established neuroma, were free of palpation-induced neuroma pain at follow-up.
Given these results, the researchers concluded that TNI may offer an effective strategy for the prevention and treatment of neuroma pain in individuals with amputations.
