Passive Blood-Flow-Restriction Exercise's Impact on Muscle Atrophy Post-Total Knee Replacement: A Randomized Trial

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• Total knee arthroplasty (TKA) often leads to postoperative muscle atrophy and weakness, complicating rehabilitation.
• Traditional rehabilitation methods can be limited by pain and poor patient adherence.
• Passive blood flow restriction (pBFR) presents a potential low-threshold intervention to mitigate early muscle loss.

Purpose of the Study:

• To assess the feasibility, safety, and early effects of in-hospital pBFR on muscle mass, swelling, and functional recovery post-TKA.
• To compare outcomes between patients receiving pBFR and those in a control group.

Main Methods:

• A prospective, single-blinded trial involving 26 patients undergoing TKA, randomized to pBFR or sham BFR.
• Intervention group received pBFR at 80% limb occlusion pressure; control group received sham BFR at 20 mmHg.
• Both groups underwent 50 minutes of daily in-hospital rehabilitation for five consecutive days, with assessments preoperatively and postoperatively.

Main Results:

• The pBFR group demonstrated significant preservation of thigh circumference and lean muscle mass, alongside reduced knee swelling, compared to the control group.
• Functional performance, measured by the 6-minute walk test, improved significantly more in the pBFR group.
• Quality of life improvements were observed in both groups, with greater gains noted in the pBFR intervention group.

Conclusions:

• Initiating pBFR on the first postoperative day is feasible, safe, and effective for preserving muscle mass and reducing swelling after TKA.
• Findings support the applicability of pBFR in older surgical populations, extending previous BFR research.
• Further investigation is recommended to explore pBFR integration into standard rehabilitation and its long-term functional benefits.