Peripheral nerve repair throughout the body with processed nerve allografts: Results from a large multicenter study
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- Bauback Safa
- Department of Plastic and Reconstructive Surgery, The Buncke Clinic San Francisco California
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- Sonu Jain
- Plastics and Reconstructive Surgery The Ohio State University Wexner Medical Center Columbus Ohio
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- Mihir J. Desai
- Department of Orthopaedic Surgery and Rehabilitation Vanderbilt University Medical Center Nashville Tennessee
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- Jeffrey A. Greenberg
- Orthopaedic Surgery, Indiana Hand to Shoulder Center Indianapolis Indiana
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- Timothy R. Niacaris
- Department of Orthopedic Surgery John Peter Smith Hospital Fort Worth Texas
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- Jason A. Nydick
- Orthopaedic Surgery, Florida Orthopaedic Institute Temple Terrace Florida
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- Fraser J. Leversedge
- Divisions of Orthopaedic Surgery and Plastic Surgery, Department of Orthopaedic Surgery Duke University Durham North Carolina
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- David M. Megee
- Plastic, Reconstructive & Hand Surgery University of Cincinnati Cincinnati Ohio
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- Jozef Zoldos
- Orthopaedic Surgery, Arizona Center for Hand Surgery Phoenix Arizona
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- Brian D. Rinker
- Division of Plastic Surgery, Department of Surgery Mayo Clinic Hospital Jacksonville Jacksonville Florida
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- Desirae M. McKee
- Department of Orthopaedic Surgery Texas Tech University Health Sciences Center Lubbock Texas
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- Brendan J. MacKay
- Department of Orthopaedic Surgery Texas Tech University Health Sciences Center Lubbock Texas
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- John V. Ingari
- Department of Orthopaedic Surgery Johns Hopkins University Baltimore Maryland
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- Leon J. Nesti
- Clinical and Experimental Orthopaedics Walter Reed National Military Medical Center Bethesda Maryland
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- Mickey Cho
- Department of Orthopaedic Surgery San Antonio Military Medical Center Houston Texas
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- Ian Lee Valerio
- Department of Plastic Surgery University of Washington Seattle Washington
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- Dennis S. Kao
- Plastics and Reconstructive Surgery The Ohio State University Wexner Medical Center Columbus Ohio
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- Yasser El‐Sheikh
- Department of Surgery, Division of Plastic Reconstructive Surgery North York General Hospital Toronto Ontario Canada
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- Renata V. Weber
- Department of Plastic and Reconstructive Surgery, Multidisciplinary Specialists Rutherford New Jersey
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- Jaimie T. Shores
- Plastic and Reconstructive Surgery, School of Medicine Johns Hopkins University Baltimore Maryland
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- Joseph F. Styron
- Department of Orthopedic Surgery Cleveland Clinic Cleveland Ohio
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- Wesley P. Thayer
- Department of Plastic Surgery Vanderbilt University Medical Center Nashville Tennessee
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- Wojciech H. Przylecki
- Department of Plastic Surgery University of Kansas Medical Center Kansas City Kansas
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- Harry A. Hoyen
- Department of Orthopedic Surgery MetroHealth System Cleveland Ohio
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- Gregory M. Buncke
- Department of Plastic and Reconstructive Surgery, The Buncke Clinic San Francisco California
Description
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Peripheral nerve damage resulting in pain, loss of sensation, or motor function may necessitate a reconstruction with a bridging material. The RANGER® Registry was designed to evaluate outcomes following nerve repair with processed nerve allograft (Avance® Nerve Graft; Axogen; Alachua, FL). Here we report on the results from the largest peripheral nerve registry to‐date.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This multicenter IRB‐approved registry study collected data from patients repaired with processed nerve allograft (PNA). Sites followed their own standard of care for patient treatment and follow‐up. Data were assessed for meaningful recovery, defined as ≥S3/M3 to remain consistent with previously published results, and comparisons were made to reference literature.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The study included 385 subjects and 624 nerve repairs. Overall, 82% meaningful recovery (MR) was achieved across sensory, mixed, and motor nerve repairs up to gaps of 70 mm. No related adverse events were reported. There were no significant differences in MR across the nerve type, age, time‐to‐repair, and smoking status subgroups in the upper extremity (<jats:italic>p</jats:italic> > .05). Significant differences were noted by the mechanism of injury subgroups between complex injures (74%) as compared to lacerations (85%) or neuroma resections (94%) (<jats:italic>p</jats:italic> = .03) and by gap length between the <15 mm and 50–70 mm gap subgroups, 91 and 69% MR, respectively (<jats:italic>p</jats:italic> = .01). Results were comparable to historical literature for nerve autograft and exceed that of conduit.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>These findings provide clinical evidence to support the continued use of PNA up to 70 mm in sensory, mixed and motor nerve repair throughout the body and across a broad patient population.</jats:p></jats:sec>
Journal
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- Microsurgery
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Microsurgery 40 (5), 527-537, 2020-02-26
Wiley
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Details 詳細情報について
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- CRID
- 1360580234581753216
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- ISSN
- 10982752
- 07381085
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- Data Source
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- Crossref