Treatment of Iatrogenic Saphenous Neuroma after Knee Arthroscopy with Excision and Allograft Reconstruction
Background:. The treatment of postoperative, painful sensory neuromas is an ongoing challenge for surgeons. Here, we describe a technique for treatment with excision and allograft reconstruction and report on early results of its use in treating painful saphenous neuromas after knee arthroscopy. Met...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2021-02-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003403 |
| _version_ | 1818738605088047104 |
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| author | Mathew D. Schur, MD Kristen M. Sochol, MD, MS Rachel Lefebvre, MD Milan Stevanovic, MD |
| author_facet | Mathew D. Schur, MD Kristen M. Sochol, MD, MS Rachel Lefebvre, MD Milan Stevanovic, MD |
| author_sort | Mathew D. Schur, MD |
| collection | DOAJ |
| description | Background:. The treatment of postoperative, painful sensory neuromas is an ongoing challenge for surgeons. Here, we describe a technique for treatment with excision and allograft reconstruction and report on early results of its use in treating painful saphenous neuromas after knee arthroscopy.
Methods:. A retrospective review of a single surgeon’s peripheral nerve clinic from January 1, 2013, to December 31, 2019, was conducted to identify post-knee arthroscopy saphenous neuroma cases in which reconstruction with processed human nerve allograft distally implanted into healthy muscle belly was performed. We examined the outcomes for each patient, including subjective pain self-assessment and need for further surgical treatment.
Results:. In total, 9 cases were identified, with patient ages ranging from 21 to 74 years. The average time to referral to peripheral nerve clinic was 31 months (range: 4–143 months). Upon exploration, all nerves were found to have a neuroma in continuity. Six of the 9 patients reported subjective improvement through final follow-up. Three of the 9 patients reported initial improvement, with recurrence of pain at/near the site of the neuroma. The average follow-up time was 9 months (range: 1–21 months).
Conclusions:. Here, we report on a novel technique of using a processed human nerve allograft after neuroma resection to provide an organized environment for bridging regenerated axons into muscle tissue. We also describe our early results using this technique to treat iatrogenic saphenous neuromas after knee arthroscopy. Results are encouraging, with 6 of the 9 patients experiencing subjective reduction in pain at final follow-up. |
| first_indexed | 2024-12-18T01:11:35Z |
| format | Article |
| id | doaj.art-9e700fc97da24b8882ebe39971dd8141 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-18T01:11:35Z |
| publishDate | 2021-02-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-9e700fc97da24b8882ebe39971dd81412022-12-21T21:26:04ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742021-02-0192e340310.1097/GOX.0000000000003403202102000-00015Treatment of Iatrogenic Saphenous Neuroma after Knee Arthroscopy with Excision and Allograft ReconstructionMathew D. Schur, MD0Kristen M. Sochol, MD, MS1Rachel Lefebvre, MD2Milan Stevanovic, MD3From the Keck School of Medicine of the University of Southern California, Los Angeles, Calif.From the Keck School of Medicine of the University of Southern California, Los Angeles, Calif.From the Keck School of Medicine of the University of Southern California, Los Angeles, Calif.From the Keck School of Medicine of the University of Southern California, Los Angeles, Calif.Background:. The treatment of postoperative, painful sensory neuromas is an ongoing challenge for surgeons. Here, we describe a technique for treatment with excision and allograft reconstruction and report on early results of its use in treating painful saphenous neuromas after knee arthroscopy. Methods:. A retrospective review of a single surgeon’s peripheral nerve clinic from January 1, 2013, to December 31, 2019, was conducted to identify post-knee arthroscopy saphenous neuroma cases in which reconstruction with processed human nerve allograft distally implanted into healthy muscle belly was performed. We examined the outcomes for each patient, including subjective pain self-assessment and need for further surgical treatment. Results:. In total, 9 cases were identified, with patient ages ranging from 21 to 74 years. The average time to referral to peripheral nerve clinic was 31 months (range: 4–143 months). Upon exploration, all nerves were found to have a neuroma in continuity. Six of the 9 patients reported subjective improvement through final follow-up. Three of the 9 patients reported initial improvement, with recurrence of pain at/near the site of the neuroma. The average follow-up time was 9 months (range: 1–21 months). Conclusions:. Here, we report on a novel technique of using a processed human nerve allograft after neuroma resection to provide an organized environment for bridging regenerated axons into muscle tissue. We also describe our early results using this technique to treat iatrogenic saphenous neuromas after knee arthroscopy. Results are encouraging, with 6 of the 9 patients experiencing subjective reduction in pain at final follow-up.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003403 |
| spellingShingle | Mathew D. Schur, MD Kristen M. Sochol, MD, MS Rachel Lefebvre, MD Milan Stevanovic, MD Treatment of Iatrogenic Saphenous Neuroma after Knee Arthroscopy with Excision and Allograft Reconstruction Plastic and Reconstructive Surgery, Global Open |
| title | Treatment of Iatrogenic Saphenous Neuroma after Knee Arthroscopy with Excision and Allograft Reconstruction |
| title_full | Treatment of Iatrogenic Saphenous Neuroma after Knee Arthroscopy with Excision and Allograft Reconstruction |
| title_fullStr | Treatment of Iatrogenic Saphenous Neuroma after Knee Arthroscopy with Excision and Allograft Reconstruction |
| title_full_unstemmed | Treatment of Iatrogenic Saphenous Neuroma after Knee Arthroscopy with Excision and Allograft Reconstruction |
| title_short | Treatment of Iatrogenic Saphenous Neuroma after Knee Arthroscopy with Excision and Allograft Reconstruction |
| title_sort | treatment of iatrogenic saphenous neuroma after knee arthroscopy with excision and allograft reconstruction |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003403 |
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