A study published in the December 2012 issue of The Journal of Bone & Joint Surgery evaluated the impact of an amputation on pain, participation in activities of daily living, and quality of life, as well as the use of a prosthesis and the risk of recurrence of the syndrome in patients with long-standing, therapy-resistant type-1 complex regional pain syndrome (CRPS). The researchers concluded that amputation may positively contribute to the lives of these patients, and patients were likely to use a prosthesis after lower-limb amputation.
Twenty-one patients who underwent an amputation of a nonfunctional limb at University Medical Center, University of Groningen, the Netherlands, between May 2000 and October 2008, because of long-standing, therapy-resistant type-1 CRPS were included in the study.
The median age was 46 years, with the interquartile range (IQR) at 37 to 51 years. The median duration of the complex regional pain syndrome was six years (IQR, two to ten years), and the median interval between the amputation and the study was five years (IQR, three to seven years). A semi-structured interview was conducted, physical examination of the residual limb was performed, and the patients completed two questionnaires.
Twenty patients (95 percent) reported an improvement in their lives, 19 (90 percent) reported a reduction in pain, 17 (81 percent) reported an improvement in mobility, and 14 (67 percent) reported an improvement in sleep.
Eighteen of the 21 patients stated that they would choose to undergo an amputation again under the same circumstances. Ten of the 15 patients with a lower-limb amputation and one of the six with an upper-limb amputation regularly used a prosthesis.
The risk of recurrence of the type-I CRPS was 24 percent.
