Objective: This review investigated the effectiveness of Blood Flow Restriction (BFR) training in postoperative rehabilitation following knee surgeries.
Materials and Methods: Clinical trials were reviewed in PubMed between November and December 2024 using predefined keywords. Methodological quality was assessed using the PEDro scale. Key outcomes included muscle strength, morphology, pain, function, performance, balance, range of motion (ROM), thigh circumference, and return to sport/activity (RTS/A) times.
Results: Nineteen studies (635 patients, mean age 14.84–69.89 years) met the eligibility criteria, with an average PEDro score of 5.84. The primary surgical diagnoses were anterior cruciate ligament reconstruction, followed by total knee arthroplasty, meniscal repair and chondral restoration, arthroscopic partial meniscectomy, and high tibial osteotomy. BFR parameters varied, with most studies using personalized tourniquet systems, proximal cuff placement, and 40–80% limb occlusion pressure. Low-intensity BFR (20–30% 1RM) was commonly applied with 30s–2min rest intervals, 2–5 sessions per week for 2–16 weeks, initiated from 2 days to over a year post-surgery. Adverse events were minimal, mainly mild discomfort. In eight studies, BFR significantly improved muscle strength compared to non-BFR protocols, while seven studies found no between-group differences. Muscle morphology changes were inconsistent, with some studies reporting superior BFR effects. Pain reduction was greater in two studies, while knee function, performance, and balance improved significantly in several trials. ROM improvements and thigh circumference changes showed mixed results. RTS/A times varied across studies.
Conclusion: BFR training is a promising rehabilitation method, offering comparable results with the traditional approach or superior benefits in various outcomes while maintaining a favorable safety profile. Future research should standardize protocols and assess long-term effects to optimize its application in knee surgery rehabilitation.