Meaningful functional recovery seen in processed nerve allograft repair of large-gap injuries

BOSTON — The use of processed nerve allografts for the repair of large-gap nerve injuries produced meaningful functional recovery, defined as S3/M3 on the MRCC scale, in most repairs, according to data presented here.

“Processed nerve allograft demonstrates meaningful recovery in sensory, mixed and motor nerve injuries between 30 mm and 65 mm,” Bauback Safa, MD, said at the American Society for Surgery of the Hand Annual Meeting. “These outcomes are consistent across the different subgroups. There were no adverse events, and the outcomes compare favorably to historical controls that are in the existing published data.”

The IRB-approved research included data from the RANGER study, which involves an ongoing, multicenter registry for the use of processed nerve allografts (Avance Nerve Graft; AxoGen).

Safa and colleagues studied information for 39 nerves (20 sensory, 16 mixed and three motor) that underwent repair of gaps between 30 mm and 65 mm. Patients’ mean age was 39 years; mean follow-up was 320 days. The mean gap length was 36 mm, and the median time to repair was 8 days.

“Overall, meaningful functional recovery was reported in 90% of all the nerve repairs, and using a higher threshold of S3+/M4 or greater, we had meaningful recovery in 62%,” Safa said. “By nerve type, 95% of sensory nerves, 88% of mixed nerves and 67% of motor nerves [had meaningful recovery]. There were no adverse events.”

Safa cited the observational nature of the study, the heterogeneous data set and lack of an active control arm as study limitations.

Reference: Safa B. Paper #6. Presented at: the American Society for Surgery of the Hand Annual Meeting; Sept. 18-20, 2014; Boston.

Disclosure: Safa receives a consulting fee from AxoGen. The study was supported by an AxoGen research grant.