With more than one million lower-limb amputations performed annually, roughly 75 percent of patients experience significant pain, which can impact their quality of life and functional capabilities. Targeted muscle reinnervation (TMR), a surgical solution involving the rerouting of amputated nerves to specific muscle targets, was originally introduced to enhance signal amplification for myoelectric prosthesis control.
In a systematic review, researchers assessed the effectiveness of TMR in reducing pain and enhancing functional outcomes for patients who have undergone lower-limb amputations. The researchers examined relevant studies between 2010 and 2023, focusing on pain reduction, functional outcomes, and patient-reported quality of life measures.
Twenty studies were eligible, encompassing a total of 778 extremities, of which 75.06 percent (n = 584) were people with lower-limb amputations. Average age was 46.66 years and patients were predominantly male (n = 70.67 percent). Seven studies (35 percent) reported functional outcomes.
Patients who underwent primary TMR exhibited lower average Patient-Reported Outcome Measurement Information System (PROMIS) scores for phantom limb pain and residual limb pain. Secondary TMR led to improvements in phantom limb pain, residual limb pain, and general limb pain as indicated by average numeric rating scale and PROMIS scores.
The systematic review underscored TMR’s potential benefits in alleviating pain, fostering post-amputation rehabilitation, and enhancing overall well-being for lower limb amputees, the review concluded.