Blood Flow Restriction Therapy

Watson, Richard; Sullivan, Breanna; Stone, Austin V.; Jacobs, Cale A.; Malone, Terry; Heebner, Nicholas R.; Noehren, Brian

doi:10.2106/jbjs.rvw.22.00062

Cited by 6 publications

(3 citation statements)

References 75 publications

(226 reference statements)

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“…BFRT uses pneumatic tourniquets timed with exercise to induce hypoxia in the muscle. This induces anaerobic metabolism in the muscle, which induces angiogenesis, reduces edema, and increases hypertrophy, all while at lower loads 16,26 . This is a potentially promising modality for the treatment of muscle tears, as seen in the case of this young athlete, and may increase the effectiveness of early rehabilitation while maintaining safe loading limits during the recovery phase after injury.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Mid-substance Isolated Vastus Medialis Rupture in a Young Athlete

Elicegui,

Stovak,

Dobrich

et al. 2023

JBJS Case Connector

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Case: This is the first documented case of an isolated traumatic vastus medialis rupture that occurred in a 14-year-old athlete after direct impact during play. Imaging confirmed a rare mid-substance rupture. The patient underwent conservative management with physical therapy augmented by blood flow restriction therapy (BFRT) and platelet-poor plasma (PPP) injection to regain full function. Conclusion: Isolated quadriceps mid-substance tears are rare. Determining an appropriate treatment technique for mid-substance tears is complex. This case documents the use of nonoperative management with BFRT and PPP to achieve full recovery and early return to play in a young athlete.

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Section: Discussionmentioning

confidence: 99%

Traumatic Mid-substance Isolated Vastus Medialis Rupture in a Young Athlete

Elicegui,

Stovak,

Dobrich

et al. 2023

JBJS Case Connector

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show abstract

“…The standard of care for patients with an acute patellar dislocation without osteochondral loose bodies or fracture is conservative. However, a recent critical review that evaluated comparative studies regarding different approaches for the treatment of first‐time patellar dislocation reported no consensus and clear guidelines on management [25]. This study aimed to evaluate the current management and potential controversies amongst experienced knee surgeries in the treatment of the first episode of patellar dislocation.…”

Section: Introductionmentioning

confidence: 99%

Management of the first episode of traumatic patellar dislocation: an international survey

D’Ambrosi

Migliorini

Cerciello

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose This international survey aimed to evaluate the potential controversies regarding the management of irst patellar dislocation amongst experienced knee surgeries in the treatment of the irst episode of patellar dislocation without osteochondral fragments. Methods An online survey was conducted from February 2021 to December 2021 to assess the global trend in the diagnosis and management of irst-time patellar dislocation without osteochondral fragments. The online survey was accessible on the homepage of the website of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA). The questionnaire consisted of multiple-choice questions and was divided into three sections. The irst section consisted of eight questions regarding demographic information, professional activity, and responder experience. The second section consisted of 13 questions regarding the approach to a irst patellar dislocation (clinical examination, imaging, and rehabilitation). The third section contained 2 questions concerning the relevance of patient characteristics to the therapeutic algorithm (age, sports, and pathoanatomical predisposing risk factors). Results A total of 438 orthopaedic surgeons worldwide completed the questionnaire. At the irst approach to diagnose a irst-time patellar dislocation, 251 (57%) of the surgeons requested plain radiographs, and 158 (36%) requested magnetic resonance imaging (MRI). In conservatively treated patients, 368 (84%) of the respondents recommended the use of a knee brace. Amongst them, 14 (3%) advocated its use for one week, 75 (17%) for two weeks, 123 (28%) for three weeks, 105 (24%) for four weeks, and 97 (22%) for six weeks. In conservatively treated patients, 215 (49%) of the surgeons recommended load to tolerance, 148 (34%) recommended 30% to 60% of the bodyweight, and 75 (17%) advised against weight-bearing. More than half of the surgeons considered a patient aged less than 35 years practising contact sports to be a candidate for the medial patello-femoral ligament (MPFL) procedure. In addition, a tibial tuberosity to trochlear groove distance (TT-TG) distance of 15 to > 20 mm (for > 75% of the surgeons) and a trochlea types C and D (for > 70% of the surgeons) were considered possible indications for direct surgical management. Conclusion At the irst approach to diagnose a irst-time patellar dislocation, plain radiographs and MRI should be performed. In conservatively treated patients, most of the surgeons recommend weight-bearing to tolerance and a knee brace during the irst four weeks, with range of motion of full extension to 30° during the irst 15 days and up to 60° for an additional 15 days. Surgical management should be performed in patients in the second and third decades of life practising contact sports and in those patients who present types C and D trochlea dysplasia and patella alta. Level of evidence IV.

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“… 1 , 2 , 3 , 4 , 5 , 6 For this reason, BFR training has shown particular promise for special populations such as elderly patients, physically impaired patients, and presurgical or postsurgical patients who are otherwise unable to tolerate high-load resistance training. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 Although the exact mechanisms contributing to the observed increases in muscle mass, muscular strength, and cardiorespiratory function associated with BFR training continue to be investigated, it is thought that the reduction in blood flow produces localized hypoxia and metabolic stress that accelerates fatigue accumulation (e.g., reduced repetitions to failure), resulting in the enhanced recruitment of type II muscle fibers, as well as stimulation of anabolic pathways and hormone secretion. 18 , 19 , 20 , 21 , 22 …”

mentioning

confidence: 99%

No Differences in Exercise Performance, Perceptual Response, or Safety Were Observed Among 3 Blood Flow Restriction Devices

Dancy,

Alexander,

Abbas

et al. 2023

Arthroscopy, Sports Medicine, and Rehabilitation

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Blood Flow Restriction Therapy

Cited by 6 publications

References 75 publications

Traumatic Mid-substance Isolated Vastus Medialis Rupture in a Young Athlete

Traumatic Mid-substance Isolated Vastus Medialis Rupture in a Young Athlete

Management of the first episode of traumatic patellar dislocation: an international survey

No Differences in Exercise Performance, Perceptual Response, or Safety Were Observed Among 3 Blood Flow Restriction Devices

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