Targeted Muscle Reinnervation – The New Standard of Care for Amputees

Targeted muscle reinnervation (TMR) is a procedure performed in patients undergoing limb amputation or in patients with painful neuromas after nerve injury. When a nerve is severed or injured, it attempts to regenerate. If the nerve does not have a clear target to regenerate toward, this process can result in a disorganized mass of nerve tissue called a neuroma. TMR involves rerouting severed or injured nerves to new muscle targets using microsurgical techniques to provide the nerve endings with a new muscle to innervate. The new muscle target encourages the nerve to regenerate in an organized fashion, rather than disorganized regeneration that can lead to neuroma formation and pain. Peripheral nerves are severed during amputation, resulting in nerve endings that can form neuromas or cause phantom limb pain. TMR can be performed after limb amputation to prevent formation of painful neuromas and decrease phantom limb pain. TMR can also improve a person's ability to use and control certain types of prosthetics. In appropriate candidates, TMR can be performed at the time of amputation or in a delayed setting after amputation.