SRS98 - Five-year outcomes of targeted muscle reinnervation for neuroma and phantom limb pain in lower limb amputees: a retrospective case series

Background argeted muscle reinnervation (TMR) is increasingly used to prevent neuroma formation and alleviate phantom limb pain (PLP) and neuroma pain (NP) after amputation. While short-term benefits are established, long-term outcomes remain poorly characterised. Methods We performed a retrospective review of lower limb amputees undergoing TMR at the Royal Free Hospital (2017–2024). Pain severity (numerical rating scale, NRS) and health-related quality of life (EQ-5D-5L) were assessed via structured telephone interviews in 2025, with patients asked to recall outcomes pre-operatively, immediately post-operatively, and at 3, 6, 12, 36, and 60 months. Satisfaction was measured using a 5-point Likert scale. Analyses included Wilcoxon signed-rank and Friedman tests. Results Eighteen patients (median age 54, range 18–70; 12 male, 6 female) were included. At 12 months, patients reported significant reductions in NRS pain (P = 0.0049, r = −0.76) and improvements in mobility (P = 0.016), pain/discomfort (P = 0.006), anxiety/depression (P = 0.024), and usual activities (P = 0.005). Improvements were sustained to 5 years, with no significant deterioration in EQ-5D domains or pain scores beyond 12 months (P > 0.05). Median satisfaction remained ≥3, and 16/18 patients stated they would undergo TMR again. Conclusions This is the first UK series to report 5-year outcomes following lower limb TMR. Early improvements in pain and quality of life appear durable long term, with high satisfaction. These findings support TMR as an effective strategy for post-amputation pain and suggest wider use. Larger multi-centre studies are needed to confirm these long-term benefits.