Alpha-2 Macroglobulin for the Treatment of Neuroma Pain in the Stump of a Below-Knee Amputee Patient

Abstract

This case report describes the successful treatment of neuroma pain in the setting of below knee amputations using alpha-2-macroglobulin (A2M). A 34-year-old female patient presented with 9 months of stump pain despite conservative treatment. The exam revealed persistent pain through rest periods and weight-bearing status during therapy. Ultrasound showed neuroma formation with neovascularization. The patient underwent two A2M hydrodissection treatments, 2 weeks apart. The patient reported significant pain relief. Ultrasound showed decreases in neovascularization and cross-sectional area of the neuroma. The patient was able to ambulate pain-free for 2 years and reported no pain since. A2M may be a treatment for patients with neuroma pain in the setting of amputations.

Keywords::

• alpha-2 macroglobulin
• interventional pain medicine
• neuroma
• neuropathy
• pain medicine
• regenerative medicine
• stem cell
• ultrasound
• ultrasound-guided
• ultrasound-guided intervention

Author contributions

Concept and design: JC de Castro. Acquisition, analysis or interpretation of data: JC de Castro, D Wang, J Strakowski, DR Emril, GC Chang Chien. Critical revisions of the manuscript for important intellectual content: JC de Castro, D Wang, J Strakowski, DR Emril, GC Chang Chien. Administrative, technical, or material support: D Wang. Supervision: JC de Castro.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.