Perioperative Blood Flow Restriction Rehabilitation in Patients Undergoing ACL Reconstruction: A Systematic Review
Blood flow restriction (BFR) rehabilitation is an emerging trend in sports medicine, especially in the setting of anterior cruciate ligament (ACL) reconstruction. BFR involves placing a cuff around the thigh that decreases the amount of blood in the knee during low-intensity resistance training and has been shown to increase muscle size via the lack of oxygen stimulating the release of certain growth factors. In addition, BFR allows for less force to be felt by the new ACL graft as low-intensity resistance is used in place of high-intensity during rehabilitation. In this study, recent BFR trials were analyzed to determine the effectiveness of BFR before and after ACL reconstruction. One of the included trials found that BFR before surgery led to better muscle endurance and blood flow to the quadriceps muscle 3 months after surgery. However, these results were not validated by a similar study, which did not find a difference in outcomes between patients that underwent BFR and those that did not. Studies with BFR after surgery found that patients in the BFR groups had increased quadriceps size, more strength, and less pain compared to control groups. The results thus far of BFR following ACL reconstruction are promising, but the lack of consensus among the analyzed studies suggests the need for further research to assess short- and long-term outcomes.
Image from “Blood Flow Restriction Therapy After Knee Surgery: Indications, Safety Considerations, and Postoperative Protocol” (DePhillipo et al)