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Targeted muscle reinnervation reduces phantom limb pain and neuroma pain while delivering sustained improvements in quality of life for up to five years after lower limb amputation.
A pioneering study has found that targeted muscle reinnervation (TMR) delivers sustained reductions in phantom limb pain (PLP) and neuroma pain, with benefits persisting for at least five years after lower limb amputation.
TMR is increasingly being used to prevent painful neuroma formation and alleviate chronic pain following limb amputation. Although previous studies have demonstrated short-term benefits, evidence on long-term outcomes has remained limited. To address this gap, investigators executed a retrospective review of lower limb amputees who underwent TMR between 2017 and 2024. In 2025, patients participated in structured telephone interviews and were asked to recall their outcomes prior to surgery, immediately after surgery, and at 3, 6, 12, 36, and 60 months postoperatively.
Pain severity was checked via the numerical rating scale (NRS), while health-related quality of life was checked via the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire. On a 5-point Likert scale, patient satisfaction was measured. The study included 18 patients, with a median age of 54 years (range, 18–70 years), comprising 12 men and 6 women. At 12 months, TMR was linked with a prominent reduction in pain severity when compared with preoperative levels (P=0.0049; r=−0.76). Patients also reported meaningful improvements across multiple quality-of-life domains, including:
Importantly, the gains attained during the first postoperative year were maintained over time. Analysis showed no vital deterioration in pain scores or EQ-5D-5L domains between 12 months and 5 years (P>0.05), indicating that improvements remained stable throughout long-term follow-up. Patient satisfaction also remained favorable. The median satisfaction score was at least 3 on a 5-point Likert scale across follow-up assessments, and 16 of 18 patients reported that they would choose to undergo TMR again.
Thus, TMR not only provides early relief from phantom limb pain and neuroma pain but also delivers durable improvements in physical function, psychological well-being, and overall quality of life.
British Journal of Surgery
SRS98 - Five-year outcomes of targeted muscle reinnervation for neuroma and phantom limb pain in lower limb amputees: a retrospective case series
Rajeev Sureshkumar et al.
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