Skip to main content
Physiatry '25 Main banner
Final Program


Final Program

837 - Impact of Targeted Muscle Reinnervation on Functional Outcomes After Non-Dysvascular Major Lower Extremity Amputation: A Retrospective Cohort Study

Thursday, February 27, 2025
5:00 PM - 6:30 PM MST
Objectives: Recent studies highlight the efficacy of targeted muscle reinnervation (TMR) in preventing symptomatic neuromas and phantom limb pain after extremity amputation. However, data on functional outcomes such as time to prosthetic fitting, K levels, and assistive device use after non-dysvascular major lower extremity amputation and TMR remain limited.  

Design: This retrospective cohort study reviewed postoperative outcomes for patients who underwent non-dysvascular major lower extremity amputation between 1/1/2014 and 12/31/2021 at a major academic medical center. Patients were categorized into TMR and non-TMR groups. Exclusion criteria included insufficient follow-up, peripheral arterial disease, diabetic wound infection, premorbid spinal cord injury, and delayed TMR ( >30 days post-amputation) to reduce confounding. Descriptive statistics were used for baseline characteristics. Kaplan-Meier curves assessed time to prosthetic fitting and K levels were tracked at 3, 6, and 12 months. Assistive device use was reported using descriptive statistics.

Results: A total of 33 participants were included in the TMR group and 43 in the non-TMR group. Baseline K levels were comparable between groups, with 24% (TMR) and 23% (non-TMR) at K2, 45% vs. 44% at K3, and 30% vs. 26% at K4. Similarly, baseline assistive device use was nearly identical, with 79% of the TMR group and 77% of the non-TMR group using no devices. Kaplan-Meier analysis yielded a p-value of 0.25, suggesting no statistically significant difference in time to prosthesis fitting. K level progression over time showed no notable differences between the groups. By 12 months, however, only 38% of TMR patients were without assistive devices compared to 70% of the non-TMR group.

Conclusions:

These findings suggest that while TMR may not significantly impact time to prosthesis fitting or K level progression, it may be associated with greater reliance on assistive devices at 12 months. Further research is needed to explore long-term functional outcomes after TMR.