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Neuroma Analysis in Humans: Standardizing Sample Collection and Documentation.

Floris V Raasveld1, Wen-Chih Liu2, Maximilian Mayrhofer-Schmid3

  • 1Department of Orthopaedic Surgery, Hand and Arm Center, Massachusetts General Hospital, Harvard Medical School, Boston Massachusetts; Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center, Erasmus University, Rotterdam, The Netherlands.

The Journal of Surgical Research
|April 16, 2024
PubMed
Summary

This study developed a protocol to analyze neuroma pain by collecting tissue and patient-reported outcomes. The findings will help understand factors contributing to painful neuromas.

Keywords:
AmputationMethodologyNeuromaNeuropathic pain

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Area of Science:

  • Neurology
  • Pain Research
  • Molecular Biology

Background:

  • Symptomatic neuromas and their associated pain mechanisms remain poorly understood.
  • Pain variability in neuromas necessitates standardized assessment protocols.
  • A knowledge gap exists regarding the molecular and clinical factors influencing neuroma pain.

Purpose of the Study:

  • To establish a comprehensive protocol for assessing neuroma pain and collecting associated tissue for molecular analysis.
  • To bridge the knowledge gap in understanding the biology of symptomatic neuromas and pain.
  • To encourage other research centers to adopt and share experiences with similar tissue collection methods.

Main Methods:

  • Detailed chart review and pain assessment immediately before surgery.
  • Collection of patient-reported outcome measures (PROMs) for pain, function, and well-being preoperatively and at 6-month follow-up.
  • Intraoperative specimen collection (neuromas and surrounding nerves) with gross anatomical recording, followed by storage for analysis (paraformaldehyde or frozen).

Main Results:

  • Successfully obtained 220 nerve tissue specimens from 83 limbs.
  • Included 95 neuroma specimens and 125 control nerve specimens.
  • Collected comprehensive clinical metadata and patient-reported outcomes.

Conclusions:

  • The outlined approach integrates macroscopic and molecular tissue examination with PROMs and clinical data.
  • This methodology provides a framework for studying the multifaceted nature of neuroma pain.
  • The study aims to facilitate further research into the underlying causes of painful neuromas.