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The Current State of Targeted Muscle Reinnervation: A Systematic Review
Amanda R Walsh1, Jocelyn Lu1, Esdras Rodriguez2
1Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Journal of Reconstructive Microsurgery
|August 21, 2022
Summary
Targeted muscle reinnervation (TMR) can reduce phantom limb pain and improve amputee quality of life. Further research is needed to standardize patient-reported outcomes for TMR procedures.
Area of Science:
- Regenerative Medicine
- Surgical Innovation
- Patient Outcomes Research
Background:
- Targeted muscle reinnervation (TMR) is an emerging surgical technique for amputees.
- Limited literature exists on patient characteristics and outcomes associated with TMR.
- This review synthesizes current evidence on TMR patient demographics and results.
Approach:
- A systematic literature search was conducted using EMBASE database.
- Keywords included "targeted muscle reinnervation" OR "TMR" AND "outcomes" OR "patient outcomes."
- 13 eligible human studies involving 338 patients were analyzed for demographics, TMR indications, procedure details, and outcomes.
Key Points:
- The review analyzed data from 338 patients across 13 studies, with amputation causes including trauma, infection, and cancer.
- TMR was performed on upper and/or lower extremities, with an average of 2.2 nerve transfers per limb.
- Delayed TMR showed significant reduction in phantom limb pain in some studies, while immediate TMR correlated with lower pain scores compared to controls.
Conclusions:
- Evidence suggests TMR can reduce neuroma pain and enhance amputee quality of life.
- Larger-scale studies are necessary to fully understand the patient experience with TMR.
- Standardized, validated patient-reported outcome measures are crucial for future TMR research.
