Regenerative peripheral nerve interface (RPNI) is a relatively new surgical technique to manage
neuromas and
phantom pain after limb
amputation. This study evaluates prophylactic RPNI efficacy in managing post-
amputation pain and
neuroma formation in amputees compared with patients in which lower limb
amputation was performed without this procedure. We included 28 patients who underwent above the knee
amputation (AKA) or below the knee
amputation (BKA) for severe
soft tissue infection from July 2019 till December 2020. All patients had
insulin-dependent diabetes. The patients were divided into two groups, 14 patients with primary RPNI and 14 patients without. We analyzed the demographic data, level of
amputation, number of RPNIs,
operative time, postoperative complications and functional outcome on the defined follow up period. The mean patient age was 68.6 years (range 49-85), 19 (67.9 %) male and 9 (32.1 %) female patients. In this study 11 (39.3 %) AKA and 17 (60.7 %) BKA were performed. Overall, 37 RPNIs were made. The mean follow-up period was 49 weeks. PROMIS T-score decreased by 15.9 points in favor for the patients with RPNI. The VAS score showed that, in the RPNI group, all 14 patients were without
pain compared to the group of patients without RPNI, where the 11 (78.6 %) patients described their
pain as severe. Patients with RPNI used
prosthesis significantly more (p < 0.005). Data showed significant reduction in
pain and high patient satisfaction after
amputation with RPNIs. This technique is oriented as to prevent
neuroma formation with RPNI surgery, performed at the time of
amputation. RPNI surgery did not provoke complications or significant lengthening of
operative time and it should be furthermore exploited as a surgical technique.