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Targeted Muscle Reinnervation as a Surgical Approach for Phantom Limb Pain Management Following Amputation

  • Amputation Rehabilitation (JM Cohen, Section Editor)
  • Published:
Current Physical Medicine and Rehabilitation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The goal of this paper is to review the current literature on targeted muscle reinnervation (TMR). This procedure has been developed over the past decade and has the potential to create intuitive and rapid control of prosthetics while also treating phantom limb and residual limb pain.

Recent Findings

In 2019, two major articles changed the way we understand the effects of the procedure. One was a randomized control trial by Dumanian et al. (Annals of Surgery 270(2):238–246, 2019) that showed that TMR improved phantom limb pain to a statistically significant degree. The other was a well-designed study by Valerio et al. (Journal of the American College of Surgeons 228(3):217–226, 2019) that revealed the incredible power of performing TMR at the time of amputation. Another article by Chang et al. (Plastic and reconstructive surgery 148(2):376–386, 2021) published in 2021 found that TMR improves ambulation rates when compared to standard treatment.

Summary

TMR is a well-studied operation that will not only treat residual and phantom limb pain, reduce opioid dependence, and improve ambulation, but also has the potential to foster intuitive control of prosthetics.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Author information

Authors and Affiliations

  1. Long Island Plastic Surgical Group, Garden City, NY, USA

    Nikhil Agrawal

  2. Division of Plastic and Reconstructive Surgery, Wang Ambulatory Care Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA

    Lisa Gfrerer, Marilyn Heng, Kyle R. Eberlin & Ian Valerio

  3. Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA

    Marilyn Heng

Authors
  1. Nikhil Agrawal
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  2. Lisa Gfrerer
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  3. Marilyn Heng
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  4. Kyle R. Eberlin
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  5. Ian Valerio
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Corresponding author

Correspondence to Ian Valerio.

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Conflict of Interest

Dr. Valerio serves as a consultant for Integra Lifesciences, Axogen, and Checkpoint Inc. Dr. Eberlin serves as a consultant for AxoGen, Integra, Checkpoint, and Tissium. Dr. Heng serves as a consultant for Zimmer-Biomet, Inc. No funds were received or utilized for the research reported in this article. Dr. Agrawal and Dr. Gfrerer have no financial interests to declare in relation to the content of this article.

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This article is part of the Topical Collection on Amputation Rehabilitation

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Agrawal, N., Gfrerer, L., Heng, M. et al. Targeted Muscle Reinnervation as a Surgical Approach for Phantom Limb Pain Management Following Amputation. Curr Phys Med Rehabil Rep 9, 200–206 (2021). https://doi.org/10.1007/s40141-021-00329-0

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