What to expect following targeted muscle reinnervation/regenerative peripheral nerve interface: Pain outcomes in an amputee population

Targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) have shown promise in improving and/or preventing neuropathic pain and reducing narcotic use in amputees. However, anecdotally, some patients experience an increase in pain in the first few months post-operatively. This study explored the pain trajectory of 22 upper and lower extremity amputees following their TMR and/or RPNI procedure in their first post-operative year, with a focus on the patterns of recovery in the first few months. Our study found an overall decrease in the amount of pain and pain medication use at various time points post-operatively. Of note, several individuals had an increase in pain or required an increase in pain medications in the first three months. Different outcomes for patients who underwent primary versus secondary surgery were seen, which has been observed in other studies. Further prospective studies are warranted to evaluate these trends in pain after TMR or RPNI surgery in individuals with major limb amputations.