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The following is a summary of “Mental Health Status and Quality of Life is Not Improved in Amputees Following Targeted Muscle Reinnervation,” published in the March 2025 issue of An International Journal of Surgical Reconstruction by Shekouhi et al.

Targeted muscle reinnervation (TMR) is an advanced surgical technique designed to enhance pain management and functional outcomes in patients who have undergone an amputation. While its efficacy in reducing residual limb pain has been well-documented, the mid-term effects of TMR on mental health and overall quality of life remain less understood. This study retrospectively reviewed the medical records of 46 patients (53 limbs) who underwent TMR and subsequently assessed their mental health and quality of life at least one year postoperatively using validated patient-reported outcome measures (PROMs). 

Standardized assessments included the Patient Health Questionnaire-9 (PHQ-9) for depression, the Post-Traumatic Stress Disorder Checklist-Specific (PCL-S) for PTSD, the Nottingham Health Profile (NHP) for general health-related quality of life, and the Quality of Life Scale (QOLS). Statistical analyses were conducted using t-tests and linear regression models to evaluate changes in pain scores and their associations with mental health outcomes. Results demonstrated a significant reduction in residual limb pain following TMR, with median Numerical Rating Scale (NRS) scores improving from 8 preoperatively to 1 postoperatively (p<0.05). Mental health PROMs were collected at a mean follow-up of 693.6 ± 411.6 days post-TMR, revealing persistent psychological challenges among this patient population. Mean scores for PHQ-9, PCL-S, NHP, and QOLS were 7.5 ± 5.6, 32.6 ± 13.2, 39.1 ± 26.3, and 74.4 ± 21.1, respectively. 

Notably, a substantial proportion of patients exhibited mental health concerns, with 55% screening positive for mild depression and 25% meeting criteria for PTSD. Furthermore, linear regression analysis identified a significant positive correlation (p<0.05) between postoperative NRS pain scores and PHQ-9 depression scores, suggesting that persistent pain may contribute to heightened depressive symptoms. These findings indicate that while TMR is highly effective in alleviating residual limb pain, its impact on mental health and quality of life is more limited, with high rates of depression and PTSD persisting among amputees. The significant association between pain severity and depressive symptoms underscores the need for comprehensive multidisciplinary care that integrates psychological support alongside surgical interventions. Future research should explore strategies to enhance mental health outcomes in amputees undergoing TMR, including early psychological interventions, tailored rehabilitation programs, and long-term follow-up to assess the evolving impact of TMR on quality of life.

Source: jprasurg.com/article/S1748-6815(25)00196-2/abstract