Authors' objectives: To determine whether there is any evidence to support the efficacy/effectiveness of Axogen® products especially those of the nerve allograft, to treat post-neuroma excision.

Authors' results and conclusions: One hundred eighteen published studies were identified from our literature search. Upon examination on the titles and abstracts of these 118 studies, 29 studies were thought to be relevant and were retrieved in full for further appraisals. The manual search identified one further study and one clinical trial protocol listed on the US National Library of Medicine’s ClinicalTrials.gov, as such, there were 31 studies overall where 6 were deemed not relevant to the objective of this review. Of the 25 studies included, twenty were in the form of case report/small case series, three studies were in the form of low quality, small size, case-controls and two systematic reviews. It should be noted that one of these two systematic review was a high-quality systematic review while the other one was a limited low quality systematic review. At present, low-level low-quality evidence provided some data on the potential meaningful recovery with Axogen in treating post-excision neuroma as well as in treating post-surgical/trauma nerve gap. This evidence has to be interpreted with caution due to the potential of selection bias in reporting, conflict of interest, unaccounted role of confounders and chance in the reported outcomes. The potential impact of low-quality primary studies is reflected in the conclusion of the high-quality recent Cochrane systematic review that did not recommend nerve repair devices over standard repair on surgical treatment of traumatic peripheral nerve injuries especially of the upper limb.

Authors' methods: A comprehensive and systematic literature search was conducted on January 16, 2024. The search was done on commercial and non-commercial medical literature databases. A combination of keywords was employed on this search. No limitation, such as on the language or date of publication, was implemented in this search. A manual search was also done on the references of the articles that were retrieved in full.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2024

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/efficacy-effectiveness-axogen-products-treat-post-neuroma-excision?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DEfficacy%2520Effectiveness%2520of%2520Axogen%2520Products%2520to%2520treat%2520Post-Neuroma%2520Excision%26f%3Alanguage-facet%3D%5BEnglish%5D%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=Efficacy%20Effectiveness%20of%20Axogen%20Products%20to%20treat%20Post-Neuroma%20Excision

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

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