Targeted Muscle Reinnervation: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain
Artikel i vetenskaplig tidskrift, 2024

Over the past decade, the field of prosthetics has witnessed significant progress, particularly in the development of surgical techniques to enhance the functionality of prosthetic limbs. Notably, novel surgical interventions have had an additional positive outcome, as individuals with amputations have reported neuropathic pain relief after undergoing such procedures. Subsequently, surgical techniques have gained increased prominence in the treatment of postamputation pain, including one such surgical advancement-targeted muscle reinnervation (TMR). TMR involves a surgical approach that reroutes severed nerves as a type of nerve transfer to "target" motor nerves and their accompanying motor end plates within nearby muscles. This technique originally aimed to create new myoelectric sites for amplified electromyography (EMG) signals to enhance prosthetic intuitive control. Subsequent work showed that TMR also could prevent the formation of painful neuromas as well as reduce postamputation neuropathic pain (e.g., Residual and Phantom Limb Pain). Indeed, multiple studies have demonstrated TMR's effectiveness in mitigating postamputation pain as well as improving prosthetic functional outcomes. However, technical variations in the procedure have been identified as it is adopted by clinics worldwide. The purpose of this article is to provide a detailed step-by-step description of the TMR procedure, serving as the foundation for an international, randomized controlled trial (ClinicalTrials.gov, NCT05009394), including nine clinics in seven countries. In this trial, TMR and two other surgical techniques for managing postamputation pain will be evaluated.

Författare

Emily Pettersen

Chalmers, Elektroteknik

Sahlgrenska universitetssjukhuset

IRCCS Istituto Ortopedico Rizzoli, Bologna

Paolo Sassu

IRCCS Istituto Ortopedico Rizzoli, Bologna

Francesca Alice Pedrini

Sahlgrenska universitetssjukhuset

IRCCS Istituto Ortopedico Rizzoli, Bologna

Hannes Granberg

Sahlgrenska universitetssjukhuset

Carina Reinholdt

Sahlgrenska universitetssjukhuset

Juan Manuel Breyer

Worker Hospital

Aidan D. Roche

University of Edinburgh

Andrew Hart

Canniesburn Plastic Surgery Unit

University of Glasgow

Adil Ladak

University of Alberta

Hollie Power

University of Alberta

Michael Leung

Dandenong Hospital

Michael Lo

Dandenong Hospital

Ian Valerio

Harvard Medical School

Kyle R. Eberlin

Harvard Medical School

Theodore A. Kung

University of Michigan

Paul S. Cederna

University of Michigan

Jason M. Souza

Ohio State University

Uniformed Services University of the Health Sciences

Oskar C. Aszmann

Medizinische Universität Wien

Jason Ko

Northwestern University

Gregory A. Dumanian

Northwestern University

Max Jair Ortiz Catalan

IRCCS Istituto Ortopedico Rizzoli, Bologna

Prometei Pain Rehabilitation Center

University of Melbourne

Sahlgrenska universitetssjukhuset

Journal of Visualized Experiments

1940-087X (ISSN)

Vol. 2024 205 e66379

Ämneskategorier

Sjukgymnastik

Kardiologi

Neurologi

Mer information

Senast uppdaterat

2024-03-22