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Changing trends in peripheral nerve repair: A two-decade TriNetX analysis of grafting techniques and the ascendancy of allografts
Journal article   Open access   Peer reviewed

Changing trends in peripheral nerve repair: A two-decade TriNetX analysis of grafting techniques and the ascendancy of allografts

Tyler Reinoso, Emerson Rowe, David Kirby, Sina Ramtin and Asif M. Ilyas
Journal of hand and microsurgery, v 18(1), pp 100395-100395
01 Jan 2026
DOI: https://doi.org/10.1016/j.jham.2025.100395
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC12754199/View
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Abstract

Avance Conduit Nerve TriNetX
Various modalities exist for repairing transected nerves not amenable to primary repair; including, autograft, vein graft, conduit, and allograft. The study was hypothesis was that there is increasing utilization of allografts for peripheral nerve repairs. The TriNetX Research Network was queried from 2002 to 2022 for all patients undergoing peripheral nerve repair. Demographic information, usage patterns, and comorbidities associated with different grafting methods by CPT were extracted and analyzed. Out of 33,262 patients undergoing peripheral nerve repair, 31,756 with available demographic data were identified and included. Primary repair cases totaled 17,159, followed by conduit (n = 9282), allograft (n = 3582), autograft (n = 2886), and vein autograft (n = 353). Noting that a cpt for an allograft was introduced in 2017, a logistical regression analysis was performed to further sub-analyze allograft usage. The utilization of allografts significantly increased in 2021–2022 compared to 2019–2020, with an odds ratio (OR) of 1.4 (95 % confidence interval [CI]: 1.1–1.7; P = 0.001), indicating a greater increase compared to autograft utilization during the same interval. The mean per-year rate of change (range) between 2017 and 2022 for nerve allograft, conduit, autograft and vein autograft was +93.4 (+16.5 to +176.5), +6.3 (−37 to +45), −1.4 (−7.5 to +7.5), and +2 (−2.5 to +6.5), respectively. This study presents a twenty-year analysis of the changing trends in nerve repair and grafting techniques employed by nerve surgeons. Conduit repair has remained a major grafting technique used among surgeons. However, since its introduction, nerve allograft repair demonstrates a consistent positive upward trend in usage within the last 6 years, In contrast, autograft usage has decreased while vein graft usage is least common with a less relevant change in usage. These trends suggest an increasing preference for allograft, potentially displacing other nerve grafting methods, including autografting.

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Collaboration types
Domestic collaboration
Web of Science research areas
Surgery
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