Targeted Muscle Reinnervation Improves Residual Limb Pain, Phantom Limb Pain, and Limb Function: A Prospective Study of 33 Major Limb Amputees
Targeted muscle reinnervation is an emerging surgical technique to treat neuroma pain whereby sensory and mixed motor nerves are transferred to nearby redundant motor nerve branches. In a recent randomized controlled trial, targeted muscle reinnervation was recently shown to reduce postamputation pa...
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| Veröffentlicht in: | Clinical orthopaedics and related research 2020-09, Vol.478 (9), p.2161-2167 |
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| creator | Mioton, Lauren M. Dumanian, Gregory A. Shah, Nikita Qiu, Cecil S. Ertl, William J. Potter, Benjamin K. Souza, Jason M. Valerio, Ian L. Ko, Jason H. Jordan, Sumanas W. |
| description | Targeted muscle reinnervation is an emerging surgical technique to treat neuroma pain whereby sensory and mixed motor nerves are transferred to nearby redundant motor nerve branches. In a recent randomized controlled trial, targeted muscle reinnervation was recently shown to reduce postamputation pain relative to conventional neuroma excision and muscle burying.
(1) Does targeted muscle reinnervation improve residual limb pain and phantom limb pain in the period before surgery to 1 year after surgery? (2) Does targeted muscle reinnervation improve Patient-reported Outcome Measurement System (PROMIS) pain intensity and pain interference scores at 1 year after surgery? (3) After 1 year, does targeted muscle reinnervation improve functional outcome scores (Orthotics Prosthetics User Survey [OPUS] with Rasch conversion and Neuro-Quality of Life [Neuro-QOL])?
Data on patients who were ineligible for randomization or declined to be randomized and underwent targeted muscle reinnervation for pain were gathered for the present analysis. Data were collected prospectively from 2013 to 2017. Forty-three patients were enrolled in the study, 10 of whom lacked 1-year follow-up, leaving 33 patients for analysis. The primary outcomes measured were the difference in residual limb and phantom limb pain before and 1 year after surgery, assessed by an 11-point numerical rating scale (NRS). Secondary outcomes were change in PROMIS pain measures and change in limb function, assessed by the OPUS Rasch for upper limbs and Neuro-QOL for lower limbs before and 1 year after surgery.
By 1 year after targeted muscle reinnervation, NRS scores for residual limb pain from 6.4 ± 2.6 to 3.6 ± 2.2 (mean difference -2.7 [95% CI -4.2 to -1.3]; p < 0.001) and phantom limb pain decreased from 6.0 ± 3.1 to 3.6 ± 2.9 (mean difference -2.4 [95% CI -3.8 to -0.9]; p < 0.001). PROMIS pain intensity and pain interference scores improved with respect to residual limb and phantom limb pain (residual limb pain intensity: 53.4 ± 9.7 to 44.4 ± 7.9, mean difference -9.0 [95% CI -14.0 to -4.0]; residual limb pain interference: 60.4 ± 9.3 to 51.7 ± 8.2, mean difference -8.7 [95% CI -13.1 to -4.4]; phantom limb pain intensity: 49.3 ± 10.4 to 43.2 ± 9.3, mean difference -6.1 [95% CI -11.3 to -0.9]; phantom limb pain interference: 57.7 ± 10.4 to 50.8 ± 9.8, mean difference -6.9 [95% CI -12.1 to -1.7]; p ≤ 0.012 for all comparisons). On functional assessment, OPUS Rasch scores improved from 53.7 ± 3.4 to 56.4 ± 3. |
| doi_str_mv | 10.1097/CORR.0000000000001323 |
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(1) Does targeted muscle reinnervation improve residual limb pain and phantom limb pain in the period before surgery to 1 year after surgery? (2) Does targeted muscle reinnervation improve Patient-reported Outcome Measurement System (PROMIS) pain intensity and pain interference scores at 1 year after surgery? (3) After 1 year, does targeted muscle reinnervation improve functional outcome scores (Orthotics Prosthetics User Survey [OPUS] with Rasch conversion and Neuro-Quality of Life [Neuro-QOL])?
Data on patients who were ineligible for randomization or declined to be randomized and underwent targeted muscle reinnervation for pain were gathered for the present analysis. Data were collected prospectively from 2013 to 2017. Forty-three patients were enrolled in the study, 10 of whom lacked 1-year follow-up, leaving 33 patients for analysis. The primary outcomes measured were the difference in residual limb and phantom limb pain before and 1 year after surgery, assessed by an 11-point numerical rating scale (NRS). Secondary outcomes were change in PROMIS pain measures and change in limb function, assessed by the OPUS Rasch for upper limbs and Neuro-QOL for lower limbs before and 1 year after surgery.
By 1 year after targeted muscle reinnervation, NRS scores for residual limb pain from 6.4 ± 2.6 to 3.6 ± 2.2 (mean difference -2.7 [95% CI -4.2 to -1.3]; p < 0.001) and phantom limb pain decreased from 6.0 ± 3.1 to 3.6 ± 2.9 (mean difference -2.4 [95% CI -3.8 to -0.9]; p < 0.001). PROMIS pain intensity and pain interference scores improved with respect to residual limb and phantom limb pain (residual limb pain intensity: 53.4 ± 9.7 to 44.4 ± 7.9, mean difference -9.0 [95% CI -14.0 to -4.0]; residual limb pain interference: 60.4 ± 9.3 to 51.7 ± 8.2, mean difference -8.7 [95% CI -13.1 to -4.4]; phantom limb pain intensity: 49.3 ± 10.4 to 43.2 ± 9.3, mean difference -6.1 [95% CI -11.3 to -0.9]; phantom limb pain interference: 57.7 ± 10.4 to 50.8 ± 9.8, mean difference -6.9 [95% CI -12.1 to -1.7]; p ≤ 0.012 for all comparisons). On functional assessment, OPUS Rasch scores improved from 53.7 ± 3.4 to 56.4 ± 3.7 (mean difference +2.7 [95% CI 2.3 to 3.2]; p < 0.001) and Neuro-QOL scores improved from 32.9 ± 1.5 to 35.2 ± 1.6 (mean difference +2.3 [95% CI 1.8 to 2.9]; p < 0.001).
Targeted muscle reinnervation demonstrates improvement in residual limb and phantom limb pain parameters in major limb amputees. It should be considered as a first-line surgical treatment option for chronic amputation-related pain in patients with major limb amputations. Additional investigation into the effect on function and quality of life should be performed.
Level IV, therapeutic study.</description><identifier>ISSN: 0009-921X</identifier><identifier>EISSN: 1528-1132</identifier><identifier>DOI: 10.1097/CORR.0000000000001323</identifier><identifier>PMID: 32452928</identifier><language>eng</language><publisher>United States: Wolters Kluwer</publisher><subject>Adult ; Amputation ; Amputation - adverse effects ; Chronic Pain - etiology ; Chronic Pain - physiopathology ; Chronic Pain - surgery ; Clinical Research ; Female ; Humans ; Limbs ; Lower Extremity - innervation ; Lower Extremity - physiopathology ; Lower Extremity - surgery ; Male ; Middle Aged ; Muscle, Skeletal - innervation ; Muscle, Skeletal - surgery ; Nerve Transfer - methods ; Nerves ; Neuroma - etiology ; Neuroma - physiopathology ; Neuroma - surgery ; Pain ; Patient Reported Outcome Measures ; Patients ; Phantom limb ; Phantom Limb - etiology ; Phantom Limb - physiopathology ; Phantom Limb - surgery ; Prospective Studies ; Prosthetics ; Quality of life ; Reinnervation ; Surgery ; Treatment Outcome ; Upper Extremity - innervation ; Upper Extremity - physiopathology ; Upper Extremity - surgery</subject><ispartof>Clinical orthopaedics and related research, 2020-09, Vol.478 (9), p.2161-2167</ispartof><rights>Wolters Kluwer</rights><rights>2020 by the Association of Bone and Joint Surgeons</rights><rights>2020 by the Association of Bone and Joint Surgeons 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4844-a9d97f0117b64f408351c25a9f4ecd5ecf4c668e17ca3c32bc139ed636c8b4463</citedby><cites>FETCH-LOGICAL-c4844-a9d97f0117b64f408351c25a9f4ecd5ecf4c668e17ca3c32bc139ed636c8b4463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431223/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431223/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32452928$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mioton, Lauren M.</creatorcontrib><creatorcontrib>Dumanian, Gregory A.</creatorcontrib><creatorcontrib>Shah, Nikita</creatorcontrib><creatorcontrib>Qiu, Cecil S.</creatorcontrib><creatorcontrib>Ertl, William J.</creatorcontrib><creatorcontrib>Potter, Benjamin K.</creatorcontrib><creatorcontrib>Souza, Jason M.</creatorcontrib><creatorcontrib>Valerio, Ian L.</creatorcontrib><creatorcontrib>Ko, Jason H.</creatorcontrib><creatorcontrib>Jordan, Sumanas W.</creatorcontrib><title>Targeted Muscle Reinnervation Improves Residual Limb Pain, Phantom Limb Pain, and Limb Function: A Prospective Study of 33 Major Limb Amputees</title><title>Clinical orthopaedics and related research</title><addtitle>Clin Orthop Relat Res</addtitle><description>Targeted muscle reinnervation is an emerging surgical technique to treat neuroma pain whereby sensory and mixed motor nerves are transferred to nearby redundant motor nerve branches. In a recent randomized controlled trial, targeted muscle reinnervation was recently shown to reduce postamputation pain relative to conventional neuroma excision and muscle burying.
(1) Does targeted muscle reinnervation improve residual limb pain and phantom limb pain in the period before surgery to 1 year after surgery? (2) Does targeted muscle reinnervation improve Patient-reported Outcome Measurement System (PROMIS) pain intensity and pain interference scores at 1 year after surgery? (3) After 1 year, does targeted muscle reinnervation improve functional outcome scores (Orthotics Prosthetics User Survey [OPUS] with Rasch conversion and Neuro-Quality of Life [Neuro-QOL])?
Data on patients who were ineligible for randomization or declined to be randomized and underwent targeted muscle reinnervation for pain were gathered for the present analysis. Data were collected prospectively from 2013 to 2017. Forty-three patients were enrolled in the study, 10 of whom lacked 1-year follow-up, leaving 33 patients for analysis. The primary outcomes measured were the difference in residual limb and phantom limb pain before and 1 year after surgery, assessed by an 11-point numerical rating scale (NRS). Secondary outcomes were change in PROMIS pain measures and change in limb function, assessed by the OPUS Rasch for upper limbs and Neuro-QOL for lower limbs before and 1 year after surgery.
By 1 year after targeted muscle reinnervation, NRS scores for residual limb pain from 6.4 ± 2.6 to 3.6 ± 2.2 (mean difference -2.7 [95% CI -4.2 to -1.3]; p < 0.001) and phantom limb pain decreased from 6.0 ± 3.1 to 3.6 ± 2.9 (mean difference -2.4 [95% CI -3.8 to -0.9]; p < 0.001). PROMIS pain intensity and pain interference scores improved with respect to residual limb and phantom limb pain (residual limb pain intensity: 53.4 ± 9.7 to 44.4 ± 7.9, mean difference -9.0 [95% CI -14.0 to -4.0]; residual limb pain interference: 60.4 ± 9.3 to 51.7 ± 8.2, mean difference -8.7 [95% CI -13.1 to -4.4]; phantom limb pain intensity: 49.3 ± 10.4 to 43.2 ± 9.3, mean difference -6.1 [95% CI -11.3 to -0.9]; phantom limb pain interference: 57.7 ± 10.4 to 50.8 ± 9.8, mean difference -6.9 [95% CI -12.1 to -1.7]; p ≤ 0.012 for all comparisons). On functional assessment, OPUS Rasch scores improved from 53.7 ± 3.4 to 56.4 ± 3.7 (mean difference +2.7 [95% CI 2.3 to 3.2]; p < 0.001) and Neuro-QOL scores improved from 32.9 ± 1.5 to 35.2 ± 1.6 (mean difference +2.3 [95% CI 1.8 to 2.9]; p < 0.001).
Targeted muscle reinnervation demonstrates improvement in residual limb and phantom limb pain parameters in major limb amputees. It should be considered as a first-line surgical treatment option for chronic amputation-related pain in patients with major limb amputations. Additional investigation into the effect on function and quality of life should be performed.
Level IV, therapeutic study.</description><subject>Adult</subject><subject>Amputation</subject><subject>Amputation - adverse effects</subject><subject>Chronic Pain - etiology</subject><subject>Chronic Pain - physiopathology</subject><subject>Chronic Pain - surgery</subject><subject>Clinical Research</subject><subject>Female</subject><subject>Humans</subject><subject>Limbs</subject><subject>Lower Extremity - innervation</subject><subject>Lower Extremity - physiopathology</subject><subject>Lower Extremity - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Muscle, Skeletal - innervation</subject><subject>Muscle, Skeletal - surgery</subject><subject>Nerve Transfer - methods</subject><subject>Nerves</subject><subject>Neuroma - etiology</subject><subject>Neuroma - physiopathology</subject><subject>Neuroma - surgery</subject><subject>Pain</subject><subject>Patient Reported Outcome Measures</subject><subject>Patients</subject><subject>Phantom limb</subject><subject>Phantom Limb - etiology</subject><subject>Phantom Limb - physiopathology</subject><subject>Phantom Limb - surgery</subject><subject>Prospective Studies</subject><subject>Prosthetics</subject><subject>Quality of life</subject><subject>Reinnervation</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Upper Extremity - innervation</subject><subject>Upper Extremity - physiopathology</subject><subject>Upper Extremity - surgery</subject><issn>0009-921X</issn><issn>1528-1132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUl1v0zAUtRCIdYOfALLECw9kxB9xEh4mVRWDSZ1WlSHxZjnOzZqS2MGOO-1P7DfjLmMq88vVOT73yNfnIvSOpKckLfPPi6v1-jQ9OIRR9gLNSEaLhETwEs0iWyYlJb-O0LH32wgZz-hrdMRorCUtZuj-WrkbGKHGl8HrDvAaWmPA7dTYWoMv-sHZHfhI-7YOqsPLtq_wSrXmE15tlBltf0gpU0_wPBi9d_iC53jlrB8gwh3gH2Oo77BtMGP4Um2tm-TzfggjgH-DXjWq8_D2sZ6gn-dfrxffk-XVt4vFfJloXnCeqLIu8yYlJK8Eb3hasIxomqmy4aDrDHTDtRAFkFwrphmtNGEl1IIJXVScC3aCzibfIVQ91BrM6FQnB9f2yt1Jq1r5_41pN_LG7mTOGaGURYOPjwbO_gngR9m3XkPXKQM2eEl5KkqekTyL0g_PpFsbnInjSZqlORciF3vDbFLp-FveQfP0GJLKfeJyn7h8nnjse384yVPXv4ijgE-CW9uN4PzvLtyCkxtQ3bh58GNpIRKa0rgtESUPa8L-Alt6tt0</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Mioton, Lauren M.</creator><creator>Dumanian, Gregory A.</creator><creator>Shah, Nikita</creator><creator>Qiu, Cecil S.</creator><creator>Ertl, William J.</creator><creator>Potter, Benjamin K.</creator><creator>Souza, Jason M.</creator><creator>Valerio, Ian L.</creator><creator>Ko, Jason H.</creator><creator>Jordan, Sumanas W.</creator><general>Wolters Kluwer</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200901</creationdate><title>Targeted Muscle Reinnervation Improves Residual Limb Pain, Phantom Limb Pain, and Limb Function: A Prospective Study of 33 Major Limb Amputees</title><author>Mioton, Lauren M. ; Dumanian, Gregory A. ; Shah, Nikita ; Qiu, Cecil S. ; Ertl, William J. ; Potter, Benjamin K. ; Souza, Jason M. ; Valerio, Ian L. ; Ko, Jason H. ; Jordan, Sumanas W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4844-a9d97f0117b64f408351c25a9f4ecd5ecf4c668e17ca3c32bc139ed636c8b4463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Amputation</topic><topic>Amputation - adverse effects</topic><topic>Chronic Pain - etiology</topic><topic>Chronic Pain - physiopathology</topic><topic>Chronic Pain - surgery</topic><topic>Clinical Research</topic><topic>Female</topic><topic>Humans</topic><topic>Limbs</topic><topic>Lower Extremity - innervation</topic><topic>Lower Extremity - physiopathology</topic><topic>Lower Extremity - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Muscle, Skeletal - innervation</topic><topic>Muscle, Skeletal - surgery</topic><topic>Nerve Transfer - methods</topic><topic>Nerves</topic><topic>Neuroma - etiology</topic><topic>Neuroma - physiopathology</topic><topic>Neuroma - surgery</topic><topic>Pain</topic><topic>Patient Reported Outcome Measures</topic><topic>Patients</topic><topic>Phantom limb</topic><topic>Phantom Limb - etiology</topic><topic>Phantom Limb - physiopathology</topic><topic>Phantom Limb - surgery</topic><topic>Prospective Studies</topic><topic>Prosthetics</topic><topic>Quality of life</topic><topic>Reinnervation</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Upper Extremity - innervation</topic><topic>Upper Extremity - physiopathology</topic><topic>Upper Extremity - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mioton, Lauren M.</creatorcontrib><creatorcontrib>Dumanian, Gregory A.</creatorcontrib><creatorcontrib>Shah, Nikita</creatorcontrib><creatorcontrib>Qiu, Cecil S.</creatorcontrib><creatorcontrib>Ertl, William J.</creatorcontrib><creatorcontrib>Potter, Benjamin K.</creatorcontrib><creatorcontrib>Souza, Jason M.</creatorcontrib><creatorcontrib>Valerio, Ian L.</creatorcontrib><creatorcontrib>Ko, Jason H.</creatorcontrib><creatorcontrib>Jordan, Sumanas W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical orthopaedics and related research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mioton, Lauren M.</au><au>Dumanian, Gregory A.</au><au>Shah, Nikita</au><au>Qiu, Cecil S.</au><au>Ertl, William J.</au><au>Potter, Benjamin K.</au><au>Souza, Jason M.</au><au>Valerio, Ian L.</au><au>Ko, Jason H.</au><au>Jordan, Sumanas W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Targeted Muscle Reinnervation Improves Residual Limb Pain, Phantom Limb Pain, and Limb Function: A Prospective Study of 33 Major Limb Amputees</atitle><jtitle>Clinical orthopaedics and related research</jtitle><addtitle>Clin Orthop Relat Res</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>478</volume><issue>9</issue><spage>2161</spage><epage>2167</epage><pages>2161-2167</pages><issn>0009-921X</issn><eissn>1528-1132</eissn><abstract>Targeted muscle reinnervation is an emerging surgical technique to treat neuroma pain whereby sensory and mixed motor nerves are transferred to nearby redundant motor nerve branches. In a recent randomized controlled trial, targeted muscle reinnervation was recently shown to reduce postamputation pain relative to conventional neuroma excision and muscle burying.
(1) Does targeted muscle reinnervation improve residual limb pain and phantom limb pain in the period before surgery to 1 year after surgery? (2) Does targeted muscle reinnervation improve Patient-reported Outcome Measurement System (PROMIS) pain intensity and pain interference scores at 1 year after surgery? (3) After 1 year, does targeted muscle reinnervation improve functional outcome scores (Orthotics Prosthetics User Survey [OPUS] with Rasch conversion and Neuro-Quality of Life [Neuro-QOL])?
Data on patients who were ineligible for randomization or declined to be randomized and underwent targeted muscle reinnervation for pain were gathered for the present analysis. Data were collected prospectively from 2013 to 2017. Forty-three patients were enrolled in the study, 10 of whom lacked 1-year follow-up, leaving 33 patients for analysis. The primary outcomes measured were the difference in residual limb and phantom limb pain before and 1 year after surgery, assessed by an 11-point numerical rating scale (NRS). Secondary outcomes were change in PROMIS pain measures and change in limb function, assessed by the OPUS Rasch for upper limbs and Neuro-QOL for lower limbs before and 1 year after surgery.
By 1 year after targeted muscle reinnervation, NRS scores for residual limb pain from 6.4 ± 2.6 to 3.6 ± 2.2 (mean difference -2.7 [95% CI -4.2 to -1.3]; p < 0.001) and phantom limb pain decreased from 6.0 ± 3.1 to 3.6 ± 2.9 (mean difference -2.4 [95% CI -3.8 to -0.9]; p < 0.001). PROMIS pain intensity and pain interference scores improved with respect to residual limb and phantom limb pain (residual limb pain intensity: 53.4 ± 9.7 to 44.4 ± 7.9, mean difference -9.0 [95% CI -14.0 to -4.0]; residual limb pain interference: 60.4 ± 9.3 to 51.7 ± 8.2, mean difference -8.7 [95% CI -13.1 to -4.4]; phantom limb pain intensity: 49.3 ± 10.4 to 43.2 ± 9.3, mean difference -6.1 [95% CI -11.3 to -0.9]; phantom limb pain interference: 57.7 ± 10.4 to 50.8 ± 9.8, mean difference -6.9 [95% CI -12.1 to -1.7]; p ≤ 0.012 for all comparisons). On functional assessment, OPUS Rasch scores improved from 53.7 ± 3.4 to 56.4 ± 3.7 (mean difference +2.7 [95% CI 2.3 to 3.2]; p < 0.001) and Neuro-QOL scores improved from 32.9 ± 1.5 to 35.2 ± 1.6 (mean difference +2.3 [95% CI 1.8 to 2.9]; p < 0.001).
Targeted muscle reinnervation demonstrates improvement in residual limb and phantom limb pain parameters in major limb amputees. It should be considered as a first-line surgical treatment option for chronic amputation-related pain in patients with major limb amputations. Additional investigation into the effect on function and quality of life should be performed.
Level IV, therapeutic study.</abstract><cop>United States</cop><pub>Wolters Kluwer</pub><pmid>32452928</pmid><doi>10.1097/CORR.0000000000001323</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical orthopaedics and related research, 2020-09, Vol.478 (9), p.2161-2167 |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adult Amputation Amputation - adverse effects Chronic Pain - etiology Chronic Pain - physiopathology Chronic Pain - surgery Clinical Research Female Humans Limbs Lower Extremity - innervation Lower Extremity - physiopathology Lower Extremity - surgery Male Middle Aged Muscle, Skeletal - innervation Muscle, Skeletal - surgery Nerve Transfer - methods Nerves Neuroma - etiology Neuroma - physiopathology Neuroma - surgery Pain Patient Reported Outcome Measures Patients Phantom limb Phantom Limb - etiology Phantom Limb - physiopathology Phantom Limb - surgery Prospective Studies Prosthetics Quality of life Reinnervation Surgery Treatment Outcome Upper Extremity - innervation Upper Extremity - physiopathology Upper Extremity - surgery |
| title | Targeted Muscle Reinnervation Improves Residual Limb Pain, Phantom Limb Pain, and Limb Function: A Prospective Study of 33 Major Limb Amputees |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T06%3A54%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Targeted%20Muscle%20Reinnervation%20Improves%20Residual%20Limb%20Pain,%20Phantom%20Limb%20Pain,%20and%20Limb%20Function:%20A%20Prospective%20Study%20of%2033%20Major%20Limb%20Amputees&rft.jtitle=Clinical%20orthopaedics%20and%20related%20research&rft.au=Mioton,%20Lauren%20M.&rft.date=2020-09-01&rft.volume=478&rft.issue=9&rft.spage=2161&rft.epage=2167&rft.pages=2161-2167&rft.issn=0009-921X&rft.eissn=1528-1132&rft_id=info:doi/10.1097/CORR.0000000000001323&rft_dat=%3Cproquest_pubme%3E2507466763%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2507466763&rft_id=info:pmid/32452928&rfr_iscdi=true |