Quick Review and Technical Approach for Regenerative Peripheral Nerve Interface Surgery

Abstract

Regenerative peripheral nerve interface RPNI’s surgery was originally designed for prosthetic control. RPNI’s has demonstrated to be an effective tool to prevent neuroma formation by providing free muscle grafts as physiological targets for peripheral nerve ingrowth. Nerve transection injuries can result in painful neuromas that adversely affect patient recovery. This is especially significant following amputation surgeries, but they can also be used in surgeries in which the nerves can be visualized with a noticeable lesion. The first series of patients undergoing RPNI implantation for treatment of symptomatic postamputation neuromas was published in 2016. The series included a report of 46 patients undergoing RPNI. The clinical outcomes of RPNI have been optimistic with a reduction in neuroma pain up to 73% and phantom pain reduction of 53% along the uniformly high patient satisfaction. Since then, studies have been expanded, and knowledge regarding physiology has increased, providing us with new tools for a better understanding and giving these procedures more benefits and applications.