Plast Reconstr Surg. 2022 Jul 6. doi: 10.1097/PRS.0000000000009441. Online ahead of print.
ABSTRACT
BACKGROUND: Targeted muscle reinnervation (TMR) has emerged as a technique to reduce neuroma and phantom limb pain after below knee amputation (BKA); however, the incidence of post-operative complications remains unknown. This multi-institutional study assessed the risk of post-operative complications among patients who underwent TMR at the time of BKA (BKA+TMR).
STUDY DESIGN: Patients who underwent BKA+TMR were propensity score-matched 1:3 to patients who underwent BKA only. Study outcomes included the incidence of major or minor complications within 60 days. Regression models were utilized to estimate the relative risk (RR) of major and minor complications.
RESULTS: Overall, 96 patients were matched including 31 BKA+TMR and 65 BKA only. In the matched sample, a higher incidence of major complications (29% vs. 24.6%), readmission (25.8% vs. 18.5%) and reoperation (19.4% vs. 10.8%) was seen after BKA+TMR compared to BKA only. Furthermore, patients who underwent BKA+TMR displayed a higher incidence of minor complications (25.8% versus 20.0%), blood transfusion (22.6% vs. 18.5%), wound healing complications (45.2% vs. 33.8%), and longer operative time (mean [standard deviation] 188.5 [63.6] vs. 88 [28.2] minutes). However, there was no statistically significant difference in the risk of major (RR:1.20, 90% confidence interval (CI):0.68, 2.11) or minor (RR:1.21, 90% CI:0.61, 2.41) complications between the two cohorts.
CONCLUSION: Despite an increased incidence of post-operative complications, undergoing BKA+TMR does not confer a statistically significant increased risk of major or minor complications. Future studies are needed to delineate patient selection criteria when assessing the suitability of TMR at the time of major limb amputation.
PMID:35791757 | DOI:10.1097/PRS.0000000000009441
