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February 22, 2026JOSPT open.0 citationsOpen Access

Blood Flow Restriction Training After Orthopaedic Procedures: A Scoping Review of Current Trends and Functional Outcome Assessments

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FLFang LiuDSDavid StocktonKHKrystal Herfst

Key Result

Blood flow restriction training after orthopaedic procedures is most studied post-ACL reconstruction, with varied protocols and outcomes across 831 patients in 30 studies.

Key Points

  • This review aims to summarize the protocols and outcome measures of blood flow restriction training after orthopaedic procedures.
  • Conducted a scoping review of existing literature on BFRT after orthopaedic procedures.
  • Searched databases including Medline, EMBASE, Cochrane, and Web of Science up to July 2024.
  • Included studies reporting function-based and patient-reported outcomes following BFRT.
  • Included 30 studies with 831 patients, primarily focused on anterior cruciate ligament reconstruction.
  • BFRT was commonly initiated within 2 weeks post-surgery in 16 studies.
  • Most reported outcomes included muscle strength, pain, and muscle size.

Structured PICO

What are the current protocols and outcome measures used in blood flow restriction training after orthopaedic procedures?

P
Population
831 patients across 30 studies who underwent orthopaedic procedures (most commonly anterior cruciate ligament reconstruction and knee arthroscopy)
I
Intervention
Blood flow restriction training (BFRT)
O
Outcome
Function-based and patient-reported outcome measures (including muscle strength, torque, endurance, pain, muscle size, and IKDC score)

There is significant heterogeneity in procedures, protocols, and outcome measures in studies evaluating blood flow restriction training after orthopaedic procedures.

Abstract

OBJECTIVE: To summarize current protocols and outcome measures used in blood flow restriction training (BFRT) after orthopaedic procedures. DESIGN: Scoping review LITERATURE SEARCH: Medline, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection were searched from inception to July 2024. STUDY SELECTION CRITERIA: We included studies of BFRT used after orthopaedic procedures, and that reported function-based and patient-reported outcome measures. DATA SYNTHESIS: Qualitative synthesis was performed to identify current BFRT protocols used following orthopaedic procedures and the function-based and patient-reported outcomes reported. Studies were categorized by procedure type, and outcomes were presented according to frequency of reporting, RESULTS: Thirty studies (831 patients) were included. The use of BFRT was most frequently studied after anterior cruciate ligament (ACL) reconstruction (18 studies) and knee arthroscopy (5 studies). There were 2 studies of BFRT after distal radius open reduction and internal fixation (ORIF), and single studies of BFTR after ankle ORIF, high tibial osteotomy, total knee arthroplasty, shoulder stabilization, and distal biceps repair. BFRT was initiated within 2 weeks post-operative in 16 studies. The most common measures were muscle strength, torque, or endurance (25 studies), pain (12 studies), muscle size or limb circumference (10 studies), and the International Knee Documentation Committee subjective knee function score (8 studies). CONCLUSION: There was heterogeneity in procedures, protocols, and outcome measures across existing BFRT studies.

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Cite This Study

Liu et al. (2026) studied this question. Blood flow restriction training after orthopaedic procedures is most studied post-ACL reconstruction, with varied protocols and outcomes across 831 patients in 30 studies.

synapsesocial.com/papers/699a9d3c482488d673cd3067https://doi.org/10.2519/josptopen.2026.0176
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Blood Flow Restriction Therapy Preserves Whole Limb Bone and Muscle Following ACL Reconstruction2019 · 32 citations
  2. 2Low-load resistance muscular training with moderate restriction of blood flow after anterior cruciate ligament reconstruction2003 · 252 citations
  3. 3Outcomes of Blood Flow Restriction Training After ACL Reconstruction in NCAA Division I Athletes2024 · 10 citations
  4. 4The Effects of Blood Flow Restriction in Patients Undergoing Knee Surgery: A Systematic Review and Meta-analysis2021 · 53 citations
  5. 5Blood Flow Restriction Training Can Improve Peak Torque Strength in Chronic Atrophic Postoperative Quadriceps and Hamstrings Muscles2021 · 23 citations