Regenerative Peripheral Nerve Interfaces for the Treatment of Painful Neuromas in Major Limb Amputees

NCT ID: NCT07285486

Last Updated: 2025-12-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

132 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-06-08

Study Completion Date

2023-06-26

Brief Summary

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The Regenerative Peripheral Nerve Interface (RPNI) is a novel strategy to prevent neuroma formation in transected peripheral nerves. The RPNI consists of a residual peripheral nerve that is implanted into a free skeletal muscle graft either at the time of limb amputation or after excision of a terminal neuroma bulb. The sprouting axons of the nerve readily reinnervate the free muscle graft, thereby greatly reducing the chance of neuroma formation.

This investigation has a prospective cohort study design involving major lower limb amputees drawn from both the University of Michigan Health Systems and VA Health System of Ann Arbor. To objectively evaluate the effect of RPNI surgery on patients' perception of pain and to measure other health-related quality of life metrics relating to neuroma pain, this clinical trial will utilize specific, validated patient-reported outcomes measures (PROMs) to assess targeted domains in patients with major limb amputation. These survey instruments will determine: 1) patterns of pain medication use, including the use of opioids, 2) functional status and use of a prosthetic device, 3) changes in neuroma pain quality, 4) limitations in activities of daily living due to neuroma pain, 5) depression and anxiety relating to neuroma pain.

Detailed Description

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Conditions

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Amputation Neuroma

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Chronic Amputation Pain

Participants who were existing amputees who had chronic neuroma pain at the amputation site.

Amputation with Regenerative Peripheral Nerve Interfaces (RPNI)

Intervention Type PROCEDURE

Free-muscle graft over cut nerve ends for treatment of neuromas at site of an amputation.

Prophylactic Treatment Group

Participants who had a lower extremity amputated during the study and were prophylactically treated for pain.

Amputation with Regenerative Peripheral Nerve Interfaces (RPNI)

Intervention Type PROCEDURE

Free-muscle graft over cut nerve ends for treatment of neuromas at site of an amputation.

Amputation Without RPNI

Intervention Type OTHER

Standard of care for lower-extremity amputation

Interventions

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Amputation with Regenerative Peripheral Nerve Interfaces (RPNI)

Free-muscle graft over cut nerve ends for treatment of neuromas at site of an amputation.

Intervention Type PROCEDURE

Amputation Without RPNI

Standard of care for lower-extremity amputation

Intervention Type OTHER

Other Intervention Names

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RPNI

Eligibility Criteria

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Inclusion Criteria

* Major lower limb amputation (chronic pain treatment group only)
* Symptomatic residual limb neuroma (chronic pain treatment group only)
* Undergoing a major lower limb amputation (prophylactic pain treatment group only)

Exclusion Criteria

* History of chronic amputation-related pain (prophylactic pain treatment group only)
* History of regenerative peripheral nerve interface (RPNI)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Theodore Alexander Kung

Principal Investogator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Theodore Kung, MD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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Department of Veterans Affairs Ann Arbor Health System

Ann Arbor, Michigan, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

Countries

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United States

References

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Lee JC, Kubiak CA, Best CSW, Hamill JB, Ki J, Kim HM, Roth RS, Kozlow JH, Tinney MJ, Geisser ME, Cederna PS, Kemp SWP, Kung TA. Regenerative Peripheral Nerve Interface Surgery to Treat Chronic Postamputation Pain: A Prospective Study in Major Lower Limb Amputation Patients. Ann Surg Open. 2025 Jan 7;6(1):e535. doi: 10.1097/AS9.0000000000000535. eCollection 2025 Mar.

Reference Type RESULT
PMID: 40134500 (View on PubMed)

Other Identifiers

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HUM00120915

Identifier Type: -

Identifier Source: org_study_id