SRS34 - An analysis of the role of Regenerative Peripheral Nerve Interface (RPNI) in pain outcomes and quality of life: a retrospective cohort study

Abstract Aim Regenerative Peripheral Nerve Interface (RPNI) surgery is a surgical technique for the management of neuroma pain (NP). The technique uses non-vascularised muscle grafts which are wrapped around the ends of freshly cut nerve stumps to provide end-organ targets into which the axons in the nerve stump can grow. The formation of new connections between the nerves and the muscle grafts reduces the tendency to reform painful neuromas. In this report, we look at the outcomes after use of RPNI to treat NP in the upper limb, health-related Quality of Life (HRQoL), pain characteristics and patient satisfaction with the procedure. Methods This was a retrospective Cohort study of outcomes for 11 patients who underwent RPNI surgery between May 2018 and April 2025. Pain was quantified on an 11-point scale (0–10), pain characteristics were calculated using Pain Intensity and Pain behaviour1,2 forms. The satisfaction survey used a 5-point Likert scale. Results 11 patients completed our surveys in full. The M:F ratio was 4:7, mean age was 51.9 ± 12.7 and median follow up was 12 months. There were significant reductions in NP (pre-operative mean: 7.7, post-operative mean: 3.5 P = 0.002). Pain intensity T score (pre-operative mean: 75.2, post-operative mean: 55, P = 0.003), Pain Interference T score (pre-operative mean: 68.1, post-operative mean: 57.2, P = 0.014) and quality-of-life metrics were also improved, whilst only phantom pain had no significant results. Conclusions This study suggests that RPNI surgery can result in statistically significant improvements in Pain and Quality of Life after nerve injury in the upper limb.