Targeted Muscle Reinnervation

TMR can reroute damaged nerves or nerves cut during amputation into motor nerves in nearby muscle, re-establishing neural circuitry and giving the nerves somewhere to go and something to do. This decreases painful neuroma formation and reduces phantom limb pain.

Regenerative peripheral nerve interface (RPNI)

Regenerative peripheral nerve interface (RPNI) surgery is performed in patients undergoing limb amputation or in patients with painful neuromas after nerve injury. When a nerve is severed or injured, it attempts to regenerate. If the nerve does not have a clear target to regenerate towards, this process can result in a disorganized mass of nerve tissue called a neuroma. RPNI surgery involves harvesting small portions of muscle from the body (muscle grafts) and placing them over severed nerve endings, providing the nerve with muscle to reinnervate. The new muscle target encourages the nerve to regenerate in an organized fashion, rather than disorganized regeneration that can lead to neuroma formation and pain.