Phantom Limb Pain and Painful Neuroma After Dysvascular Lower-Extremity Amputation: A Systematic Review and Meta-Analysis
Background Phantom limb pain (PLP) and symptomatic neuroma can be debilitating and significantly impact the quality of life of amputees. However, the prevalence of PLP and symptomatic neuromas in patients following dysvascular lower limb amputation (LLA) has not been reliably established. This syste...
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Veröffentlicht in: | Vascular and endovascular surgery 2024-02, Vol.58 (2), p.142-150 |
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creator | Langeveld, Mirte Bosman, Romy Hundepool, Caroline A. Duraku, Liron S. McGhee, Christopher Zuidam, J. Michiel Barker, Tom Juszczak, Maciej Power, Dominic M. |
description | Background
Phantom limb pain (PLP) and symptomatic neuroma can be debilitating and significantly impact the quality of life of amputees. However, the prevalence of PLP and symptomatic neuromas in patients following dysvascular lower limb amputation (LLA) has not been reliably established. This systematic review and meta-analysis evaluates the prevalence and incidence of phantom limb pain and symptomatic neuroma after dysvascular LLA.
Methods
Four databases (Embase, MEDLINE, Cochrane Central, and Web of Science) were searched on October 5th, 2022. Prospective or retrospective observational cohort studies or cross-sectional studies reporting either the prevalence or incidence of phantom limb pain and/or symptomatic neuroma following dysvascular LLA were identified. Two reviewers independently conducted the screening, data extraction, and the risk of bias assessment according to the PRISMA guidelines. To estimate the prevalence of phantom limb pain, a meta-analysis using a random effects model was performed.
Results
Twelve articles were included in the quantitative analysis, including 1924 amputees. A meta-analysis demonstrated that 69% of patients after dysvascular LLA experience phantom limb pain (95% CI 53-86%). The reported pain intensity on a scale from 0-10 in LLA patients ranged between 2.3 ± 1.4 and 5.5 ± .7. A single study reported an incidence of symptomatic neuroma following dysvascular LLA of 5%.
Conclusions
This meta-analysis demonstrates the high prevalence of phantom limb pain after dysvascular LLA. Given the often prolonged and disabling nature of neuropathic pain and the difficulties managing it, more consideration needs to be given to strategies to prevent it at the time of amputation. |
doi_str_mv | 10.1177/15385744231197097 |
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Phantom limb pain (PLP) and symptomatic neuroma can be debilitating and significantly impact the quality of life of amputees. However, the prevalence of PLP and symptomatic neuromas in patients following dysvascular lower limb amputation (LLA) has not been reliably established. This systematic review and meta-analysis evaluates the prevalence and incidence of phantom limb pain and symptomatic neuroma after dysvascular LLA.
Methods
Four databases (Embase, MEDLINE, Cochrane Central, and Web of Science) were searched on October 5th, 2022. Prospective or retrospective observational cohort studies or cross-sectional studies reporting either the prevalence or incidence of phantom limb pain and/or symptomatic neuroma following dysvascular LLA were identified. Two reviewers independently conducted the screening, data extraction, and the risk of bias assessment according to the PRISMA guidelines. To estimate the prevalence of phantom limb pain, a meta-analysis using a random effects model was performed.
Results
Twelve articles were included in the quantitative analysis, including 1924 amputees. A meta-analysis demonstrated that 69% of patients after dysvascular LLA experience phantom limb pain (95% CI 53-86%). The reported pain intensity on a scale from 0-10 in LLA patients ranged between 2.3 ± 1.4 and 5.5 ± .7. A single study reported an incidence of symptomatic neuroma following dysvascular LLA of 5%.
Conclusions
This meta-analysis demonstrates the high prevalence of phantom limb pain after dysvascular LLA. Given the often prolonged and disabling nature of neuropathic pain and the difficulties managing it, more consideration needs to be given to strategies to prevent it at the time of amputation.</description><identifier>ISSN: 1538-5744</identifier><identifier>EISSN: 1938-9116</identifier><identifier>DOI: 10.1177/15385744231197097</identifier><identifier>PMID: 37616476</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Amputation, Surgical - adverse effects ; Cross-Sectional Studies ; Extremities ; Humans ; Lower Extremity ; Neuroma - diagnosis ; Neuroma - epidemiology ; Neuroma - surgery ; Phantom Limb - diagnosis ; Phantom Limb - epidemiology ; Phantom Limb - etiology ; Prospective Studies ; Quality of Life ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Vascular and endovascular surgery, 2024-02, Vol.58 (2), p.142-150</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c335t-56a10f05a309996eb2d4097afa974345f45977ab08dac076fad09ae1b5483bbd3</cites><orcidid>0000-0001-6849-5036</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/15385744231197097$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/15385744231197097$$EHTML$$P50$$Gsage$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37616476$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Langeveld, Mirte</creatorcontrib><creatorcontrib>Bosman, Romy</creatorcontrib><creatorcontrib>Hundepool, Caroline A.</creatorcontrib><creatorcontrib>Duraku, Liron S.</creatorcontrib><creatorcontrib>McGhee, Christopher</creatorcontrib><creatorcontrib>Zuidam, J. Michiel</creatorcontrib><creatorcontrib>Barker, Tom</creatorcontrib><creatorcontrib>Juszczak, Maciej</creatorcontrib><creatorcontrib>Power, Dominic M.</creatorcontrib><title>Phantom Limb Pain and Painful Neuroma After Dysvascular Lower-Extremity Amputation: A Systematic Review and Meta-Analysis</title><title>Vascular and endovascular surgery</title><addtitle>Vasc Endovascular Surg</addtitle><description>Background
Phantom limb pain (PLP) and symptomatic neuroma can be debilitating and significantly impact the quality of life of amputees. However, the prevalence of PLP and symptomatic neuromas in patients following dysvascular lower limb amputation (LLA) has not been reliably established. This systematic review and meta-analysis evaluates the prevalence and incidence of phantom limb pain and symptomatic neuroma after dysvascular LLA.
Methods
Four databases (Embase, MEDLINE, Cochrane Central, and Web of Science) were searched on October 5th, 2022. Prospective or retrospective observational cohort studies or cross-sectional studies reporting either the prevalence or incidence of phantom limb pain and/or symptomatic neuroma following dysvascular LLA were identified. Two reviewers independently conducted the screening, data extraction, and the risk of bias assessment according to the PRISMA guidelines. To estimate the prevalence of phantom limb pain, a meta-analysis using a random effects model was performed.
Results
Twelve articles were included in the quantitative analysis, including 1924 amputees. A meta-analysis demonstrated that 69% of patients after dysvascular LLA experience phantom limb pain (95% CI 53-86%). The reported pain intensity on a scale from 0-10 in LLA patients ranged between 2.3 ± 1.4 and 5.5 ± .7. A single study reported an incidence of symptomatic neuroma following dysvascular LLA of 5%.
Conclusions
This meta-analysis demonstrates the high prevalence of phantom limb pain after dysvascular LLA. Given the often prolonged and disabling nature of neuropathic pain and the difficulties managing it, more consideration needs to be given to strategies to prevent it at the time of amputation.</description><subject>Amputation, Surgical - adverse effects</subject><subject>Cross-Sectional Studies</subject><subject>Extremities</subject><subject>Humans</subject><subject>Lower Extremity</subject><subject>Neuroma - diagnosis</subject><subject>Neuroma - epidemiology</subject><subject>Neuroma - surgery</subject><subject>Phantom Limb - diagnosis</subject><subject>Phantom Limb - epidemiology</subject><subject>Phantom Limb - etiology</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>1538-5744</issn><issn>1938-9116</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>EIF</sourceid><recordid>eNp9kMlOxDAMhiMEYn8ALihHLoVkkjYNt4pdGhaxnCu3daGoaYckZejbk2GACxIn2_LnX_JHyB5nh5wrdcRjkcZKyongXCum1QrZ5FqkkeY8WQ192EcLYINsOffKGE-5TNfJhlAJT6RKNsl49wKd7w2dNqagd9B0FLrqq6mHlt7gYHsDNKs9Wno6undw5dCCpdN-jjY6-_AWTeNHmpnZ4ME3fXdMM_owOo8mjCW9x_cG51-p1-ghyjpoR9e4HbJWQ-tw97tuk6fzs8eTy2h6e3F1kk2jUojYR3ECnNUsBsG01gkWk0qGT6EGraSQcS1jrRQULK2gZCqpoWIakBexTEVRVGKbHCxzZ7Z_G9D53DSuxLaFDvvB5ZOgMJWKMR1QvkRL2ztnsc5ntjFgx5yzfGE8_2M83Ox_xw-Fwer34kdxAA6XgINnzF_7wQYB7p_ET2RQiWM</recordid><startdate>202402</startdate><enddate>202402</enddate><creator>Langeveld, Mirte</creator><creator>Bosman, Romy</creator><creator>Hundepool, Caroline A.</creator><creator>Duraku, Liron S.</creator><creator>McGhee, Christopher</creator><creator>Zuidam, J. Michiel</creator><creator>Barker, Tom</creator><creator>Juszczak, Maciej</creator><creator>Power, Dominic M.</creator><general>SAGE Publications</general><scope>AFRWT</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6849-5036</orcidid></search><sort><creationdate>202402</creationdate><title>Phantom Limb Pain and Painful Neuroma After Dysvascular Lower-Extremity Amputation: A Systematic Review and Meta-Analysis</title><author>Langeveld, Mirte ; Bosman, Romy ; Hundepool, Caroline A. ; Duraku, Liron S. ; McGhee, Christopher ; Zuidam, J. Michiel ; Barker, Tom ; Juszczak, Maciej ; Power, Dominic M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c335t-56a10f05a309996eb2d4097afa974345f45977ab08dac076fad09ae1b5483bbd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Amputation, Surgical - adverse effects</topic><topic>Cross-Sectional Studies</topic><topic>Extremities</topic><topic>Humans</topic><topic>Lower Extremity</topic><topic>Neuroma - diagnosis</topic><topic>Neuroma - epidemiology</topic><topic>Neuroma - surgery</topic><topic>Phantom Limb - diagnosis</topic><topic>Phantom Limb - epidemiology</topic><topic>Phantom Limb - etiology</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Langeveld, Mirte</creatorcontrib><creatorcontrib>Bosman, Romy</creatorcontrib><creatorcontrib>Hundepool, Caroline A.</creatorcontrib><creatorcontrib>Duraku, Liron S.</creatorcontrib><creatorcontrib>McGhee, Christopher</creatorcontrib><creatorcontrib>Zuidam, J. Michiel</creatorcontrib><creatorcontrib>Barker, Tom</creatorcontrib><creatorcontrib>Juszczak, Maciej</creatorcontrib><creatorcontrib>Power, Dominic M.</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Vascular and endovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Langeveld, Mirte</au><au>Bosman, Romy</au><au>Hundepool, Caroline A.</au><au>Duraku, Liron S.</au><au>McGhee, Christopher</au><au>Zuidam, J. Michiel</au><au>Barker, Tom</au><au>Juszczak, Maciej</au><au>Power, Dominic M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Phantom Limb Pain and Painful Neuroma After Dysvascular Lower-Extremity Amputation: A Systematic Review and Meta-Analysis</atitle><jtitle>Vascular and endovascular surgery</jtitle><addtitle>Vasc Endovascular Surg</addtitle><date>2024-02</date><risdate>2024</risdate><volume>58</volume><issue>2</issue><spage>142</spage><epage>150</epage><pages>142-150</pages><issn>1538-5744</issn><eissn>1938-9116</eissn><abstract>Background
Phantom limb pain (PLP) and symptomatic neuroma can be debilitating and significantly impact the quality of life of amputees. However, the prevalence of PLP and symptomatic neuromas in patients following dysvascular lower limb amputation (LLA) has not been reliably established. This systematic review and meta-analysis evaluates the prevalence and incidence of phantom limb pain and symptomatic neuroma after dysvascular LLA.
Methods
Four databases (Embase, MEDLINE, Cochrane Central, and Web of Science) were searched on October 5th, 2022. Prospective or retrospective observational cohort studies or cross-sectional studies reporting either the prevalence or incidence of phantom limb pain and/or symptomatic neuroma following dysvascular LLA were identified. Two reviewers independently conducted the screening, data extraction, and the risk of bias assessment according to the PRISMA guidelines. To estimate the prevalence of phantom limb pain, a meta-analysis using a random effects model was performed.
Results
Twelve articles were included in the quantitative analysis, including 1924 amputees. A meta-analysis demonstrated that 69% of patients after dysvascular LLA experience phantom limb pain (95% CI 53-86%). The reported pain intensity on a scale from 0-10 in LLA patients ranged between 2.3 ± 1.4 and 5.5 ± .7. A single study reported an incidence of symptomatic neuroma following dysvascular LLA of 5%.
Conclusions
This meta-analysis demonstrates the high prevalence of phantom limb pain after dysvascular LLA. Given the often prolonged and disabling nature of neuropathic pain and the difficulties managing it, more consideration needs to be given to strategies to prevent it at the time of amputation.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>37616476</pmid><doi>10.1177/15385744231197097</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6849-5036</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Amputation, Surgical - adverse effects Cross-Sectional Studies Extremities Humans Lower Extremity Neuroma - diagnosis Neuroma - epidemiology Neuroma - surgery Phantom Limb - diagnosis Phantom Limb - epidemiology Phantom Limb - etiology Prospective Studies Quality of Life Retrospective Studies Treatment Outcome |
title | Phantom Limb Pain and Painful Neuroma After Dysvascular Lower-Extremity Amputation: A Systematic Review and Meta-Analysis |
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