biostudies-literatureTendijck GAHZonMwZorginstituut Nederlande105053https://www.ebi.ac.uk/biostudies/studies/S-EPMC12587972biostudies-literatureUnknown15(11)<h4>Introduction</h4>In the Netherlands, approximately 2200 major amputations of the lower extremities are performed each year, the majority in vascular patients. Around 61% of these patients will develop postamputation pain (PAP). PAP is a severe, lifelong, disabling condition profoundly affecting quality of life. During amputations, the common practice is to cut the nerves without employing nerve-surgical techniques to prevent chronic pain due to neuroma formation. In recent years, targeted muscle reinnervation (TMR) has been the most frequently studied technique for treating PAP, inhibiting neuroma formation by rerouting the cut mixed nerve to a functional motor nerve. We hypothesise that a primary TMR procedure during major lower limb amputations will result in a lower prevalence of PABMJ openPrevention of postamputation pain with targeted muscle reinnervation (PreventPAP trial): protocol for a national, multicentre, randomised, sham-controlled trial.PMC125879722023039665Verduijn PSNiesters MJong TMalessy MJASteenhoven TJVvan den Hout WBde Ruiter GCWPondaag WPreventPAP consortiumPloeg AJZuidam JMvan Zwet EWvan de Water WRijken BDuraku LSvan Schaik JKwee EMees BMEWijk MPVvan Rijt WGGroen JLJongkind VCoert JHvan der Krogt HDijkman RROvergoor MLEYeung KKBrakkee EMTendijck GAHfalsePrevention of postamputation pain with targeted muscle reinnervation (PreventPAP trial): protocol for a national, multicentre, randomised, sham-controlled trial.<h4>Introduction</h4>In the Netherlands, approximately 2200 major amputations of the lower extremities are performed each year, the majority in vascular patients. Around 61% of these patients will develop postamputation pain (PAP). PAP is a severe, lifelong, disabling condition profoundly affecting quality of life. During amputations, the common practice is to cut the nerves without employing nerve-surgical techniques to prevent chronic pain due to neuroma formation. In recent years, targeted muscle reinnervation (TMR) has been the most frequently studied technique for treating PAP, inhibiting neuroma formation by rerouting the cut mixed nerve to a functional motor nerve. We hypothesise that a primary TMR procedure during major lower limb amputations will result in a lower prevalence of PA2025-01-01T00:00:00Z2025 Nov2026-06-05T17:56:51.911Z2026-05-19T03:11:53.23ZS-EPMC125879724124841110.1136/bmjopen-2025-105053