Targeted muscle reinnervation is associated with significant analgesic-sparing effect in Asian post-amputation patients: Early utilisation and clinical outcomes.

PurposeTo evaluate early clinical outcomes of targeted muscle reinnervation (TMR) for post-amputation pain in an East Asian population and to describe its utilisation in Hong Kong.MethodsAll patients who underwent major limb amputation with TMR at our institution from January 2017 to December 2024 were reviewed. Fourteen patients (16 TMR procedures) with a minimum of 6 months follow-up were case matched to 16 control patients who underwent major limb amputation without TMR. Primary outcomes were post-amputation pain and analgesic use at latest follow-up (≥6 months). Secondary outcomes included operation time, length of stay (LOS), and 30-day and 90-day readmission and reoperation rates. Territory-wide utilisation of TMR was calculated using Hong Kong Public Hospital data system.ResultsOverall TMR utilisation in Hong Kong was 0.46% (35/7529 major amputations) over 8 years. At latest follow-up, only 5 patients (35.7%) in the TMR group required analgesics, while there were 12 patients (75.0%) requiring analgesics in the control group (P=0.030). Opioid analgesic use (with or without other analgesics) was significantly lower in the TMR group compared with controls (7.1% vs 50.0%; P=0.013). Residual limb pain (RLP), phantom limb pain (PLP) and neuropathic pain were numerically lower in the TMR group but did not reach statistical significance. Operation times, LOS, and 30-day and 90-day readmission and reoperation rates were comparable between groups (P>0.05).ConclusionTMR was associated with significantly reduced analgesic use, especially opioids, without increased surgical complications in our cohort of East Asians, verifying that clinical effectiveness of TMR could be reproduced in an Asian locality. Despite growing international evidence supporting TMR, its utilisation in Hong Kong remained very low. Clinician caring for patient with major limb amputation should be aware of the efficacy of TMR and increase its utilisation.