Clinical outcomes of delayed targeted muscle reinnervation for neuroma pain reduction in longstanding amputees

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Publication date: Available online 17 May 2019

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Dominika A. Michno, Alexander C.S. Woollard, Norbert V. Kang

Summary

Targeted muscle reinnervation (TMR) was first developed at Northwestern University in Illinois with the aim of creating a nerve - machine interface which could improve the control of myoelectric prostheses. Unexpectedly, patients who have undergone this procedure have been reporting a significant reduction in their residual limb associated pain. Current evidence suggests that TMR may be used to manage neuroma- related and phantom limb pain in amputees. To date, there is little data regarding the outcomes of TMR on neuroma and phantom limb pain in patients who have been longstanding amputees prior to surgery. We describe a cohort of patients who have undergone TMR surgery 18 or more years after their original amputation and provide further evidence which suggests that the efficacy of this procedure is unaffected by the duration of amputation nor how well the pain pathways have been established in the residual limb.