Deeyor Sorka T, Kisana Haroon M, Hui Clayton H, Stecher Chad, Hustedt Joshua W
Department of Orthopedics, University of Arizona College of Medicine-Phoenix, Phoenix, Ariz.
College of Health Solutions, Arizona State University, Tempe, Ariz.
Plast Reconstr Surg Glob Open. 2022 Aug 24;10(8):e4488. doi: 10.1097/GOX.0000000000004488. eCollection 2022 Aug.
Targeted muscle reinnervation (TMR) has shown promise in reducing postsurgical limb pain in amputees. However, there has been little evidence on the increased risk of complications and cost as compared with traditional amputations. This study was designed to assess the rate of complications and healthcare costs between those treated with TMR and traditional amputations.
Patients undergoing amputation were selected from the PearlDiver Mariner dataset and categorized into one of two treatment groups depending on the use of TMR versus traditional amputation. Rates of postsurgical complications and overall healthcare costs were compared between the two groups, while controlling for differences in patient demographics and comorbidities.
One hundred sixteen TMR procedures and 76,412 traditional amputations were included in the study. The rate of complications did not differ between groups, with a complication rate of 77% in the TMR and 87% in the traditional amputation groups. Overall healthcare costs also did not differ 1 year after surgery, with an average cost of $32,632 in the TMR group and $36,219 in the traditional amputation group.
Amputees experience high rates of postsurgical complications, morbidity, and mortality. However, there is no increased risk of complications or cost with the use of TMR. TMR has the potential benefits of reducing overall postsurgical pain and reestablishing activities of daily living. Although TMR is more expensive up front, it may reduce the overall healthcare costs by reducing the need for subsequent care. Further work is needed in large, randomized trials to examine these findings.
靶向肌肉再支配术（TMR）在减轻截肢患者术后肢体疼痛方面已显示出前景。然而，与传统截肢术相比，关于并发症风险增加和成本的证据很少。本研究旨在评估接受TMR治疗的患者与接受传统截肢术的患者之间的并发症发生率和医疗成本。
从PearlDiver Mariner数据集中选取接受截肢手术的患者，并根据是否使用TMR或传统截肢术分为两个治疗组之一。比较两组之间的术后并发症发生率和总体医疗成本，同时控制患者人口统计学和合并症的差异。
本研究纳入了116例TMR手术和76412例传统截肢手术。两组之间的并发症发生率没有差异，TMR组的并发症发生率为77%，传统截肢组为87%。术后1年总体医疗成本也没有差异，TMR组的平均成本为32632美元，传统截肢组为36219美元。
截肢患者术后并发症、发病率和死亡率较高。然而，使用TMR不会增加并发症风险或成本。TMR具有减轻总体术后疼痛和恢复日常生活活动的潜在益处。虽然TMR前期成本更高，但它可能通过减少后续护理需求来降低总体医疗成本。需要在大型随机试验中进一步开展工作以检验这些发现。
