Targeted Muscle Reinnervation

Targeted muscle reinnervation allows patients to achieve a new level of function with prosthetic devices and an improved quality of life. While the journey to recovery can be long and demanding, patients are often able to resume many of their pre-amputation activities. For those undergoing immediate TMR, the risk of phantom limb pain or stump pain is significantly decreased. In delayed TMR cases, many patients experience relief of chronic pain.

• Regain basic limb mobility and control
• Reanimate muscles to enhance prosthetic use and control
• Reduce limb pain through redirected nerve signals
• Prevent problematic muscle contraction and spasms
• Improve ability to perform daily tasks and self-care
• Prepare for advanced prosthetic fitting and use
• Reduce phantom limb pain sensations

Are you a candidate?

Patients who have undergone an amputation without TMR may be candidates for a delayed TMR procedure if they are experiencing difficulties with prosthetic control and/or tolerance. Delayed TMR procedures may also be performed to alleviate chronic pain following an amputation, such as phantom limb pain or stump pain.

Before

Targeted muscle reinnervation may be performed at the time of an amputation (immediate TMR) or after an amputation (delayed TMR). An immediate TMR procedure has the ability to provide patients with improved prosthetic control and a quicker return to everyday life following an amputation. 

During

The surgeon will make incisions around your residual limb at the amputation site and locate the major nerves that previously controlled your amputated limb. Next, the surgeon will cut those nerves and then stitch the ends into nearby nerves that control functionally redundant muscles or small pockets of muscle tissue in your residual limb. 

After

Patients typically need to stay in the hospital for 1-3 nights after a TMR procedure prior to discharge home. The hospital stay allows us to closely monitor for bleeding, circulation, and nerve function in the immediate postoperative period. Frequent neurological checks will be done, and the affected limb will be immobilized and protected. Pain and discomfort are common, and medication will be given to manage post-surgical discomfort.

Recovery

Following surgery, the nerve endings will regenerate and grow into the muscle over a period of months. You may experience some numbness, tingling, or twitching as the nerves regrow. You may begin physical therapy as early as 2-4 weeks after surgery to train your brain to control the reinnervated muscles. After 1-2 months, physical therapy progresses to heavy strengthening and myoelectric prosthetic training may start (if applicable). With practice, you will be able to contract specific muscle areas to send signals that control the movements of your prosthetic hand or joint.