D162. Patient Reported Pain after Lower Limb Osseointegration with and without Targeted Muscle Innervation

PURPOSE: Pain is a significant challenge in patients with lower limb amputations. Osseointegrated protheses are an alternative for patients with poorly tolerated socket-based prostheses. Targeted muscle reinnervation (TMR) is often done concurrently to alleviate pain and prevent future neuroma development. METHODS: A retrospective analysis was performed on patients who received single-stage lower limb osseointegration at our institution between 2017 and 2022. Patient-reported pain scores were reviewed on a scale of 0-10. T-tests were performed to compare pain scores between timepoints. RESULTS: Our study included 100 patients. The average pre-operative pain was 3.92 out of 10. The first post-operative pain evaluation occurred on average 64 days after implantation, and the last follow-up evaluation occurred on average 431 days after implantation. In patients with TMR (45), pain decreased from 4.15 to 2.27 at the first post-operative evaluation (p<0.004). In patients without TMR, pain decreased from 3.87 to 1.69 (p<0.0002). There were no significant changes in pain from the first post-operative evaluation to the last evaluation. Pain scores in patients who developed new neuromas(11) did not significantly change after implantation. However, in patients without new neuromas(82), pain decreased from 3.88 pre-operatively to 1.70 (p<0.001) post-operatively. CONCLUSION: Osseointegration prostheses with and without TMR are associated with decreased pain in lower limb amputees. Our findings suggest that most of the reduction in pain occurs early post-operatively and that pain does not return over time. The combination of Osseointegration and TMR are powerful tools in the reduction of residual limb pain for amputees.