Page 11 - Orthofeed 2022_issue1_June

Does Blood Flow Restriction Therapy Improve Leg Strength in Patients with a Painful Total Knee Arthroplasty ? 10

Surgery

Does Blood Flow Restriction Therapy Improve Leg Strength in Patients with a
Painful Total Knee Arthroplasty ?

Endorsed by: Dr. Raghav K Barve, Orthopedic Surgeon, Bone and Joint Clinic, Pune

Background
Around 20% of patients are unsatisfied with total knee arthroplasty (TKA) because of residual pain. 1

In 13% of painful TKAs, the cause of pain is unknown and revision without knowing the cause of pain
is usually unsuccessful. 1

After TKA, persistent quadriceps weakness is associated with development of flexion instability
(FI). 2

Blood flow restriction (BFR) therapy combines venous occlusion with low-load resistance training
for the development of muscle strength and hypertrophy. 3

This study investigated the effect of BFR with standard physiotherapy (PT) versus PT alone in
improving quadriceps and hamstring strength in patients with instability and weakness >1 year after

primary TKA. 2

Anaerobic Increased anabolic
metabolism hormones

Metabolic stress Increased muscle
Venous Cellular swelling Increased protein
occlusion and mechanical synthesis strength and
tension hypertrophy

Increased
Induction of type myogenic stem
2 muscle fibres
cells

Fig: Hypothesized mechanism of BFR for development of muscle strength and hypertrophy 2,3

Methods
2

This study retrospectively reviewed 48 patients Exclusion criteria
between July 2016 and January 2019. Patients Global instability

were evaluated by joint arthroplasty surgeons. Prosthetic joint infection
Implant loosening
Inclusion criteria <6 weeks of BFR or PT alone
FI after TKA

Primary TKA without prior revision surgery
Minimum 6 weeks of BFR or PT alone