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Massachusetts General Hospital & Harvard Medical School

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Medicine

Regenerative Peripheral Nerve Interface: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain
Emily Pettersen 1,2,3,4, Paolo Sassu 5, Francesca Alice Pedrini 1,5, Hannes Granberg 1,2, Carina Reinholdt 2,6, Juan Manuel Breyer 7, Aidan Roche 8, Andrew Hart 9,10, Adil Ladak 11, Hollie A. Power 11, Michael Leung 12, Michael Lo 12, Ian Valerio 13, Kyle R. Eberlin 13, Jason Ko 14, Gregory A. Dumanian 14, Theodore A. Kung 15, Paul Cederna 15, Max Ortiz-Catalan 1,4,16,17
1Center for Bionics and Pain Research, 2Center for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, 3Department of Electrical Engineering, Chalmers University of Technology, 4Bionics Institute, 5IV Clinica Ortoplastica, IRCCS Istituto Ortopedico Rizzoli, 6Department of Hand Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, 7Department of Orthopedic Surgery, Hand Unit, Worker Hospital, 8College of Medicine and Veterinary Medicine, The Queen's Medical Research Institute, The University of Edinburgh, 9Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 10College of Medicine, Veterinary & Life Sciences, The University of Glasgow, 11Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 12Plastics and Reconstructive Surgery, Dandenong Hospital, Monash Health, 13Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital & Harvard Medical School, 14Division of Plastic Surgery, Department of Surgery, Northwestern Feinberg School of Medicine, 15Section of Plastic Surgery, Department of Surgery, Michigan Medicine, 16Medical Bionics Department, University of Melbourne, 17Prometei Pain Rehabilitation Center

Here, we describe the surgical procedure to perform Regenerative Peripheral Nerve Interface (RPNI) surgery for treating postamputation neuropathic pain in the context of an international, randomized controlled trial (RCT) (ClinicalTrials.gov, NCT05009394). The RCT compares RPNI with two other surgical techniques, namely, Targeted Muscle Reinnervation (TMR) and neuroma excision combined with intra-muscular transposition.

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