Targeted Muscle Reinnervation: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain

The scope of this research is on surgical treatments for post amputation pain after major limb loss. We're trying to answer the question of whether surgical procedures in which nerves are allowed to re-innervate muscles again are more effective in treating post amputation pain than simply borrowing them in already innervated muscles. The number of limb amputation is limited within any given hospital, and these are often performed for different reasons.

Therefore, obtaining a uniform patient population is challenging. Additionally, achieving consistency in surgical procedure poses practical challenges due to variations in the level of amputation and traumatic damage resulting in diverse anatomical structures of residual limbs. This protocol provides a standardized method to perform the targeted muscle re-innervation technique, which was agreed upon by a large consortium of experienced surgeons.

This standardization will minimize bias in our randomized control trial and would allow the technique to be used and implemented in other clinics conducting amputation care.