Mental health status and quality of life is not improved in amputees following targeted muscle reinnervation

Abstract

Introduction

Targeted muscle reinnervation (TMR) in amputee patients is a surgical intervention that has shown promise in improving pain and functional outcomes. However, limited research exists regarding its effects on midterm mental health and the quality of life in amputees.

Methods

A chart review was conducted for 46 patients (53 limbs) who underwent TMR. Patients were contacted after at least 1 year and assessed for mental health and quality of life using standardized patient-reported outcome measures (PROMs), including the patient health questionnaire-9 (PHQ-9), posttraumatic stress disorder (PTSD) checklist-specific (PCL-S), Nottingham health profile (NHP), and quality of life scale (QOLS). Data were analyzed using t-tests and linear regression models.

Results

Patients reported significant improvements in residual limb pain, with median preoperative numerical rating scale (NRS) scores of 8 improving to 1 post-operatively (p < 0.05). Mental health PROMs were administered at a mean of 693.6 + 411.6 days following TMR. Mean PHQ-9, PCL-S, NHP, and QOLS scores were 7.5 ± 5.6, 32.6 ± 13.2, 39.1 ± 26.3, and 74.4 ± 21.1, respectively. There was a high prevalence of mental health disorders, with 55% of the patients exhibiting PHQ-9 scores indicating mild depression, while 25% screened positive for PTSD. Linear regression showed a significant positive correlation (p < 0.05) between post-operative NRS and PHQ-9 (depression) scores.

Conclusion

Although TMR effectively reduces residual pain in amputees, its effect on mental health and quality of life is limited. High rates of depression and PTSD remain prevalent in this population. High NRS scores correlate with increased depression scores.