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Surgery for lower extremity symptomatic neuroma: Long-term outcomes
Navapong Anantavorasakul1, Jonathan Lans2, Arno A Macken2
1Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Upper Extremity and Reconstructive Unit, Institute of Orthopaedics, Lerdsin Hospital, Department of Orthopaedic Surgery, College of Medicine, Rangsit University.
Surgical treatment for lower extremity neuromas improves pain for many patients, but persistent pain can occur. Factors like smoking and depression negatively impact outcomes, highlighting the need for comprehensive patient care.
Area of Science:
- Orthopedic Surgery
- Pain Management
- Patient-Reported Outcomes
Background:
- Traumatic neuromas cause significant neuropathic pain and functional impairment.
- These conditions negatively impact patients' quality of life.
Purpose of the Study:
- To identify factors associated with successful treatment of symptomatic lower extremity neuromas.
- Utilized patient-reported outcome measures (PROMs) to assess treatment success.
Main Methods:
- 32 patients with 48 neuromas underwent surgical treatment.
- PROMIS mobility, pain interference, depression, and NRS pain scales were used pre- and post-operatively.
- Multivariable analysis identified factors influencing PROMs.
Main Results:
- Significant reduction in Numeric Rating Scale (NRS) pain post-surgery (7.3 to 4.9).
- Higher PROMIS depression scores correlated with worse mobility, pain interference, and NRS pain.
- Smoking was independently associated with higher NRS pain scores.
Conclusions:
- Surgical treatment offers long-term improvement for 59% of patients with lower extremity neuromas.
- 19% of patients experienced severe persistent pain post-surgery.
- Smoking and negative mood adversely affect patient-reported outcomes after neuroma surgery.
