Blood flow restriction added to usual care exercise in patients with early weight bearing restrictions after cartilage or meniscus repair in the knee joint: a feasibility study

Review written by Dr Nicholas Rolnick info

Key Points

  1. Atrophy following surgery is a major problem that can impact long-term recovery.
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Within days following limb immobilization or weightbearing restrictions, local muscular atrophy occurs that disproportionately impacts anti-gravity musculature (e.g. gluteals, quadriceps, and gastroc-soleus complex), harming the recovery process (1). Following cartilage or meniscus repair surgeries, weightbearing restrictions are advised to reduce the potential disturbance of the surgical site and to promote healing.

Recently, a technique called blood flow restriction (BFR) has been utilized in the orthopedic setting to challenge load compromised patients using low loads (20-30% 1 rep max) or no weights at all (2), potentially providing a solution to combat post-surgical loss of muscle and function during the initial rehabilitation period.

The purpose of this paper was to investigate whether the addition of 9 weeks of supervised and unsupervised (at home) low-load BFR to usual care was feasible in a cohort of patients following meniscus or cartilage repair.

BFR has been used to combat local muscle atrophy that occurs within days of immobilization or weightbearing restrictions.
Blood flow restriction training can be a great adjunct to traditional rehabilitation, but we should respect the potential for it to induce unfavorable acute responses despite its benefits.


  • This study investigated the effects of 9 weeks of low-load BFR added to usual care beginning at week 4 (see Figure 1) in 42 patients with cartilage repair (n = 21) or meniscus repair (n = 21).
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