Reconstructive Center for Lost Limbs

Amputees aren't defined by what we remove but what we restore...

Glenn Gaston, MD

The OrthoCarolina Reconstructive Center for Lost Limbs (RCLL) is a multidisciplinary program dedicated to the comprehensive care of patients with limb loss or complex amputation-related conditions. We focus on advanced surgical reconstruction, prosthetic optimization, and long-term functional restoration.

Our philosophy views amputation care as reconstructive care, with the goal of maximizing function, reducing pain, and restoring independence.

Patients are supported through every stage of recovery, from initial evaluation through surgical treatment, rehabilitation, and advanced prosthetic integration.

Multidisciplinary Amputation Care

The RCLL brings together a highly specialized team of experts to deliver coordinated care tailored to each patient’s needs.

Our integrated approach ensures both physical and emotional aspects of limb loss are addressed in a unified treatment plan.

Conditions We Treat

The Reconstructive Center for Lost Limbs evaluates and treats a wide range of amputation-related and limb loss conditions, including:

• Traumatic upper and lower extremity amputations
• Infection-related amputations
• Tumor-related limb loss
• Vascular disease leading to limb loss
• Partial hand and digit amputations
• Complex residual limb pain (including neuromas and phantom limb pain)
• Difficult or failed prior amputations or revisions
• High-complexity multi-limb amputations

Research and Innovation

The RCLL is internationally recognized for advancements in limb reconstruction and amputation care, including:

• Development of the Starfish Procedure
• Advances in TMR and RPNI techniques
• Research in phantom limb pain and neurorehabilitation
• Collaboration with national and international surgical organizations
• Ongoing clinical trials and outcomes research

These innovations directly translate into improved patient outcomes and prosthetic function.

Recognition and Academic Leadership

Our physicians are widely published and recognized leaders in upper extremity reconstruction and amputation care, contributing to peer-reviewed research, surgical innovation, and global education in reconstructive techniques.

Make an Appointment

We evaluate patients with limb loss from trauma, infection, tumor, and vascular conditions with a focus on definitive reconstruction and functional restoration.

To schedule an appointment, please contact: RCLL@orthocarolina.com.

Advanced Surgical Techniques

Our surgeons utilize state-of-the-art reconstructive techniques designed to improve prosthetic control, reduce nerve pain, and optimize long-term function.

Procedures include:

• Targeted Muscle Reinnervation (TMR)
• Regenerative Peripheral Nerve Interface (RPNI)
• Starfish Procedure for independent digit prosthetic control
• Nerve reconstruction and neuroma management
• Residual limb optimization procedures
• Revision amputation surgery
• Soft tissue reconstruction for prosthetic fitting

These techniques are designed to improve both pain control and prosthetic functionality.

Pain Management and Neuroma Care

A key focus of treatment is addressing nerve-related pain following amputation.

Our approach includes:

• Surgical nerve management (TMR and RPNI)
• Neuroma prevention and treatment
• Phantom limb pain management strategies
• Medication optimization when appropriate
• Advanced non-operative pain interventions
• Emerging neuro-rehabilitative approaches

Targeted Brain Rehabilitation (TBR)

For patients experiencing phantom limb pain, our team is actively developing and implementing Targeted Brain Rehabilitation (TBR), an innovative program using virtual reality to retrain brain pathways associated with the missing limb.

This approach aims to:

• Reduce phantom limb pain
• Improve cortical reorganization after amputation
• Complement surgical nerve management strategies
• Enhance long-term quality of life

Prosthetic Optimization and Functional Restoration

We work closely with prosthetists to maximize prosthetic fit, control, and usability.

Care may include:

• Myoelectric prosthetic integration
• Advanced socket and limb fitting strategies
• Functional retraining and occupational therapy
• Motor control training following nerve transfers
• Return-to-activity and independence planning