A SYSTEMATIC REVIEW OF BLOOD FLOW RESTRICTION THERAPY IN POST-ACL RECONSTRUCTION REHABILITATION

Abstract

Background: Anterior cruciate ligament reconstruction (ACLR) often results in significant quadriceps muscle atrophy and weakness, limiting functional recovery. Blood flow restriction (BFR) therapy has emerged as a low-load training modality to mitigate these deficits during early rehabilitation.

Objective: To systematically review the efficacy and safety of BFR therapy in improving muscle strength, hypertrophy, and functional outcomes following ACLR.

Methods: A comprehensive literature search was conducted across multiple databases to identify randomized controlled trials and observational studies investigating BFR application during ACLR rehabilitation. Outcomes included muscle cross-sectional area, strength, functional scores, and adverse events.

Results: BFR therapy applied during early postoperative rehabilitation yielded significant improvements in quadriceps strength (6–18%) and muscle hypertrophy (7–15%) compared to controls. Functional scores (Lysholm, KOOS) also improved with BFR. No serious adverse events were reported. Variability in BFR protocols was noted.

Conclusion: BFR is an effective, safe adjunct to conventional ACLR rehabilitation, promoting early muscle recovery while minimizing joint stress. Standardized protocols and long-term studies are needed to optimize clinical application.