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Clinical Outcomes of Targeted Muscle Reinnervation: A Systematic Review of the Literature
Cody L. Mullens, James Gatherwright, Anna Crawford, Rebecca Knackstedt
Cleveland Clinic Foundation
2020-01-28
Presenter: Cody L. Mullens
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: Steven Bernard
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Targeted muscle reinnervation (TMR) offers the promise to alleviate pain and improve functionality for amputees. The aim of our study was to provide a systematic review of clinical outcomes related to TMR.
Indexed searches with any range of publication date were conducted in Ovid Medline, Cochrane Library, Scopus, and Web of Science. A combination of Medical Subject Headings (MeSH) and keyword terms were used to create individualized search queries regarding TMR and amputees adapted appropriately to each database.
603 unique references were identified, 14 of which were included assessments of TMR clinical outcomes. Eight manuscripts assessed pain-related outcomes. All eight demonstrated improvement in patient reported pain, but only three of the studies utilized standardized parameters for assessing pain. Additionally, two studies suggested that TMR contributed to lower rates of opioid prescriptions post-TMR. The other six studies assessed patients' abilities to utilize advanced prostheses following TMR. Overall, TMR seemed to improve amputees' ability to perform fine and gross motor movement tasks more efficiently. One study assessed ability of TMR patients to perform numerous activities of daily living, which may indirectly suggest that TMR may improve quality of life.
There is growing evidence that TMR can both alleviate pain and improve advanced prosthesis function among limb amputees. Assessment of how TMR impacts overall quality of life among amputee's should be a future direction of TMR outcomes. Additionally, future efforts to assess clinical outcomes of TMR should strongly consider utilizing standardized metrics for collecting and reporting data such as pain and functional outcomes.
