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Surgical treatment outcome of painful traumatic neuroma of the infrapatellar branch of the saphenous nerve during total knee arthroplasty

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World Journal of Orthopedics 2021年第12期12卷 1008-1015页

作者： Byron Chalidis Dimitrios Kitridis Panagiotis Givissis The First Orthopaedic Department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 57010Greece

BACKGROUND Development of infrapatellar saphenous neuroma(ISN)is a well-recognized reason for knee pain following total knee arthroplasty(TKA).So far,very few studies have addressed the development of painful ISN after TKA and its impact on functional outcome and patient *** To present the results of surgical treatment for ISN after primary TKA,the level of pain relief,and the improvement of knee motion and *** Fifteen patients(13 women,2 men)with persistent medial pain for more than six months after primary TKA,due to osteoarthritis,underwent surgical excision of *** diagnosis was confirmed with the presence of Tinel’s sign along the course of the infrapatellar branch of the saphenous nerve and with pain relief after selective nerve block using local *** loosening,malalignment,instability and infection were excluded systematically in all patients as a source of *** relief in terms of visual analog scale(VAS),active knee range of motion(ROM),and the Knee Society Score(KSS)for pain and function were evaluated preoperatively and at least six months *** The mean patients’age was 71.3±5.4 years *** mean interval between TKA and neuroma excision was 10 mo(range,6 to 14 mo),while the mean follow-up was 8 mo(range:6 to 11 mo).All 15 patients experienced almost complete immediate pain relief and resolution of allodynia and hyperesthesia after *** on the VAS scale improved from 8.6±1.3 preoperatively to 0.8±0.9 at the final follow-up(P=0.001).KSS pain and function scores were improved from 49.3±5.9 and 62.7±12.8 before surgery to 91.8±4.2 and 75.3±11.3 after surgery,respectively(P=0.001 and P=0.015).Active knee ROM was also increased postoperatively from 96±4 to 105±6 degrees(P=0.001).There were no complications and no further operations *** ISN should be considered a potential cause of persistent pain following *** excision not only provides immediate pain relief an

关键词： Total knee arthroplasty Infrapatellar branch of saphenous nerve neuroma Neurogenic pain Knee osteoarthritis

Radiofrequency Thermo-Ablation of Morton’s neuroma: A Valid Minimally Invasive Treatment Procedure in Patients Resistant to Conservative Treatment

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Open Journal of Orthopedics 2013年第8期3卷 325-330页

作者： Ronconi Paolo Arcioni Roberto Baleanu Petre Mihai Foot Medical Hospital Rome Italy Foot Medical Hospital Rome Italy 2Pain Unit Sant’Andrea Hospital University of Rome “La Sapienza” Rome Italy. Pain Unit Sant’Andrea Hospital University of Rome “La Sapienza” Rome Italy

Background: The authors present the personal results of the review of a group of cases treated for Morton’s neuroma with continuous radiofrequency (CRF) thermo-ablation of the plantar intermetatarsal nerve. Methods: This retrospective review consisted of 29 patients treated between January 2008 and December 2011, with a minimum 1 year follow-up. Three patients underwent bilateral treatment and 10 patients underwent concomitant treatment procedures for associated foot disorders: hallux valgus (7), tailor’s bunion (2) and hammertoe (5). The procedure was performed in a day hospital setting under direct fluoroscopic control. Results: The follow-up protocol used a visual analog scale (VAS) for pain (0 = no pain, 10 = worst pain) and a visual analog scale (VAS) for patient satisfaction (0 = no satisfaction, 10 = complete satisfaction). Success was defined by a decrease of 5 points in pain at 1 year after the treatment procedure. From these 29 cases, with a VAS pain score between severe and worst pain ever, treatment with CRF thermo-ablation at one year follow-up yielded these results: 14 cases with no pain (48%), 7 cases with mild pain (24%), 5 cases with moderate pain (17%), 3 cases still with severe pain (10%). The overall benefit was that 88% of the patients had significant pain improvements. From another point of view, 26 cases (89.6%) had a decrease of the VAS score between 5 and 10 points and in only 3 cases (10.3%) severe pain was reported, even though it was slightly diminished after the procedure. Conclusion: Continuous radiofrequency (CRF) thermo-ablation of Morton’s neuroma (Entrapment) was a safe and minimally invasive surgical procedure which gave these patients great satisfactions and a rapid return to normal activity.

关键词： Morton’s neuroma Continuous Radiofrequency (CRF) Thermo-Ablation

Does Greek Foot Predispose to Morton’s neuroma?

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Open Journal of Orthopedics 2014年第7期4卷 176-182页

作者： Christopher Jump Michael Rice Daniel Gheorghiu Jordi Sanchez-Ballester Department of Orthopaedics and Trauma St. Helens and Knowsley NHS Trust Liverpool UK Liverpool Medical School University of Liverpool Liverpool UK

Background: Morton’s neuroma is the enlargement of an interdigital nerve most commonly located between the third and fourth metatarsals. Greek foot is a normal variant where the first metatarsal is shorter than the second metatarsal. To our knowledge, there is currently no reported association between Greek foot and Morton’s neuroma in the literature. Methods: Retrospective study of 184 patients. Two separate cohorts were recruited. Cohort A comprised of 100 randomly selected asymptomatic patients. Cohort B comprised of 84 patients with a history of foot pain and histologically confirmed Morton’s neuroma. Foot shape was determined by using a self-assessment tool and plain radiographs. Statistical analyses were performed using the Chi-square test on the association between Greek foot and Morton’s neuroma. A p-value of ﹣9). Conclusions: This study has shown a possible association between the presence of a Greek foot and the presence of Morton’s neuroma. Although our study design has limitations and does not allow full statistical analysis, we do believe that the shown association between Greek foot and Morton’s neuroma can help clinicians and other health care providers in establishing the diagnosis of Morton’s neuroma in patients with a painful foot.

关键词： Morton’s neuroma Greek Foot Egyptian Foot Foot Pain

Palisaded encapsulated neuroma of the upper lip

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Open Journal of Stomatology 2012年第3期2卷 228-233页

作者： Kayo Kuyama Hirotaka Oomine Yan Sun Masanobu Wakami Hirotsugu Yamamoto Department of Crown and Bridge Prosthodontics Nihon University School of Dentistry at Matsudo Matsudo Japan Department of Diagnostic Pathology Hospital of Nihon University School of Dentistry at Matsudo Matsudo Japan Department of Maxillo-Facial Orthodontics Nihon University School of Dentistry at Matsudo Department of Oral Pathology Nihon University School of Dentistry at Matsudo Matsudo Japan

Palisaded encapsulated neuroma (PEN;solitary circumscribed neuroma) is a benign and hyperplastic lesion consisting of Schwann cells. PEN of the lower lip was reported by Tomich and Moll [1] 35 years ago. However, the accumulation of the information about PEN which occurred in the oral mucosa was not enough. This article describes a case of a PEN on the upper lip of a 41-year-old woman. The lesion with 0.7 cm diameter was performed excisional biopsy. Histologically, the tumor was almost circumscribed by thin fibrous capsule, and consisted of diffusely and dense proliferation of the spindle shape cells arranged in interlacing fascicles. Focal suggestions of nuclear pal-isaded growth were indicated within the tumor. Immunohistochemicallly, the fascicles of tumor cells were positive for S-100 protein, and vimentin and negative for α-actin and GFAP. A few numbers of axons were demonstrated by anti-neurofilament antibody in this lesion. Therefore, the definitive diagnosis was PEN.

关键词： Palisaded Encapsulated neuroma Solitary Circumscribed neuroma Immunohistochemistry

The Treatment of Morton’s neuroma, a Significant Cause of Metatarsalgia for People Who Exercise

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International Journal of Clinical Medicine 2013年第1期4卷 19-24页

作者： Balalis Konstantine Topalidou Anastasia Balali Catherine Tzagarakis George Katonis Pavlos University of Crete—Faculty of Medicine Department of Orthopaedics and Traumatology University Hospital of Heraklion Heraklion Greece University of the Aegean Mitilini Greece

Morton’s neuroma is a common metatarsalgia in athletes created due to the entrapment of the inter-digital nerve inside the transverse inter-metatarsal ligament. The purpose of the present study is to draw the necessary conclusions from the use of a particular surgical treatment to release the digital nerve, accompanied by neurolysis in adults who exercise. On the whole, twenty five patients with twenty-five suffering extremities were treated. Five of them simultaneously had a Hallux Valgus type deformity and that supports the belief of the mechanical induce of this condition. Both ultrasonography and Magnetic Resonance Imaging (MRI) were used for the clinical evaluation of this condition. The pain was estimated via the Visual Analogue Scale (VAS). The patients were re-examined after three (1st postoperative), twelve (2nd postoperative) and twenty-four (3rd postoperative) months. A significant improvement (p 0.0001) was noticed from the correlation between the pain before the surgery and the pain after the surgery via the Visual Analogue Scale (VAS). Most patients (15/25) did not display any discomfort or sensory disorder after surgery. The correct clinical evaluation as well as the correct and effective surgical intervention with the simultaneous repair of all the mechanical deformities of the foot provided better post-surgery progress in patients and increased the percentage of their rehabilitation of their previous activities.

关键词： Morton’s neuroma Neurolysis Metatarsalgia Surgical Technique

Role of imaging methods in diagnosis and treatment of Morton's neuroma

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World Journal of Radiology 2018年第9期10卷 91-99页

作者： Fernando Ruiz Santiago Pablo Tomas Munoz Patel Pryest Alberto Martinez Martínez Nicolás Prados Olleta Radiology Department Hospital of Neuro-Traumatology(Virgen de las Nieves)Granada 18014Spain Radiology Department North Tyneside General HospitalNorth Shields NE29 8NHUnited Kingdom Orthopaedic Department Hospital of Neuro-Traumatology(Virgen de las Nieves)Granada 18014Spain

Among the many causes of forefoot pain, Morton's neuroma(MN) is often suspected, particularly in women, due to its high ***, there remain controversies about its relationship with symptomatology and which diagnostic and treatment choices to *** article mainly focuses on the role of the various imaging methods and their abilities to support an accurate diagnosis of MN, ruling out other causes of forefoot pain, and as a way of providing targeted imaging-guided therapy for patients with MN.

关键词： Morton’s neuroma Diagnosis Infiltrative Imaging Therapy

Morton’s neuroma;Surgical Exploration Is an Option in Symptomatic Patients with Normal Investigation

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Open Journal of Orthopedics 2018年第11期8卷 413-417页

作者： Syed Mohsin Ali Mujtaba Ahmed Siddiqi King Abdullah Medical City Hospital Manama Bahrain National Guard Hospital Al-Hassa Saudi Arabia

Morton neuroma is well described problem to metatarsophalangeal Joint (MTPJ) Etiology of Morton’s neuroma which has wide range of problems from trauma, and nerve hypertrophy etc. Clinical evaluation is very important for diagnosis and sometimes investigations like ultrasound or MRI scan are helpful for conformation of diagnosis. Management varies from orthotics, shoe modification, injections or surgical excision. We are reporting a case which showed importance of surgical exploration when investigation is normal and difficulty in making diagnosis clinically.

关键词： neuroma MRI Orthotics Exploration Hypertrophy

Mechanism of the inhibition of neuroma formation by autogenous nerve replantation in situ after amputation in rabbits

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Journal of Medical Colleges of PLA(China) 1993年第4期8卷 315-318页

作者：刘会敏陈咏莲叶挺军臧鸿声 Department of Pathology Changzheng HospitalSecond Military Medical UniversityShanghai 200003

Two experimental patterns of autogenous nerve replantation in situ and centrocentralnerve suture were performed on the rabbit median and ulnar *** results of light andtransmission electron microscopy as well as immunohistochemistry showed that autogenous nervereplantation in situ could inhibit the formation of *** mechanism might be that twoproximal stump axons could touch within the interpolated graft *** end-to-endnerve suture failed to inhibit neuroma development because of a lack of proper environment forthe touching between two proximal stump axons.

关键词： neuroma replantation median and ulnar nerve animal rabbits

Clinical associations of corneal neuromas with ocular surface diseases

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Neural Regeneration Research 2024年第1期19卷 140-147页

作者： Charmaine Jan Li Toh Chang Liu Isabelle Xin Yu Lee Molly Tzu Yu Lin Louis Tong Yu-Chi Liu Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore Singapore Eye Research Institute Singapore Department of Cornea and External Eye Disease Singapore National Eye CentreSingapore Ophthalmology and Visual Sciences Academic Clinical Program Duke-NUS Medical SchoolSingapore

Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or *** formation of corneal neuromas results from damage to corneal nerves,such as following corneal pathology or corneal or intraocular surge ***,denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers,and later injured axons regenerate and new sprouts called neuromas *** recent years,analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy,a non-invasive imaging technique with microscopic resolution,has been used to evaluate corneal neuropathy and ocular surface *** neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes,and are a promising surrogate biomarker for ocular surface diseases,such as neuropathic corneal pain,dry eye disease,diabetic corneal neuropathy,neurotrophic keratopathy,Sjogren's syndrome,bullous keratopathy,post-refra ctive surgery,and *** this review,we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas,as well as elaborated on their pathogenesis,visualization via in vivo confocal microscopy,and utility in monitoring treatment *** current quantitative analysis on neuromas mainly relies on manual annotation and quantification,which is user-dependent and labor-intensive,future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner,allowing it to be applied in clinical settings more *** imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases.

关键词： cornea corneal diseases corneal nerve corneal neuropathy in vivo confocal microscopy microneuroma neuroma ocular surface diseases