A novel platelet-rich plasma-filled collagen tube reliably clinically restores meaningful sensory and motor function despite simultaneous long nerve gaps, long repair delays, and increasing age: a case series

Introduction Autografts, the clinical “gold standard” technique for restoring function across peripheral nerve gaps, have significant limitations, including sacrificing a sensory nerve and reliably restoring function only for short gaps (<4 cm), short repair delays (<5 months), and young patients (<25). As the value of any of these variables increases, recovery decreases, and when the values of 2–3 variables increase simultaneously, recovery is significantly less. Methods This non-blinded, non-controlled case series involved bridging nerve gaps with a novel composition of a never-before-clinically-tested platelet-rich plasma (PRP) within a collagen tube. Before repairing the gaps, the proximal and distal nerve stumps were cut back more extensively than normal to remove potential scar tissue. Results Meaningful sensory function was restored to 70% of the nerves, with each nerve developing sensitivity to 4–8 of 8 different types of sensory stimuli, 70% developing fingertip static 2-point discrimination ≤15 mm, and 40% developing meaningful motor function. Meaningful function was restored despite all patients having simultaneously large values of 2–3 of the variables of gap length, repair delay, and age, which normally restrict recovery. Conclusion PRP of a novel composition, which the authors recently showed rapidly and reliably eliminates chronic neuropathic pain in all patients, restored meaningful sensory and motor function, despite simultaneously high values of 2–3 of the variables of gap length, repair delay, and age, which normally restrict or prevent recovery. The results show that this technique induces meaningful sensory and motor function, even under very challenging conditions.