Preoperative blood flow restriction training combined with postoperative continuous passive motion in elderly patients after total knee arthroplasty: study protocol for a randomized controlled trial.

Abstract

Background: Postoperative rehabilitation is essential for functional recovery following total knee arthroplasty (TKA), a surgical treatment frequently used to treat knee joint problems. By briefly limiting blood supply to the limbs, blood flow restriction (BFR) training is a new and widely used rehabilitation technique that improves muscle strength and endurance. In the context of postoperative recovery after total knee arthroplasty (TKA), it has recently drawn a lot of attention. The purpose of this study is to assess how well postoperative continuous passive motion (CPM) and preoperative BFR training can enhance rehabilitation results for older patients having total knee arthroplasty. If successful, this strategy could provide a novel supplement to traditional rehabilitation methods for this population.

Methods: This study is a randomized controlled trial comprising 160 TKA patients, who will be randomly allocated to either the combined intervention group or the CPM group, with 80 individuals in each cohort. All patients will have standard preoperative treatment. The intervention group will also undergo preoperative BFR training twice daily for 2-3 days before surgery, in conjunction with postoperative CPM therapy. Joint range of motion (ROM), visual analog scale (VAS) score, activities of daily living (ADL) score, hospital for special surgery (HSS) knee score, postoperative swelling (change in knee joint circumference), C-reactive protein (CRP) levels, and 30-s chair stand test (30s-CST) performance are among the outcome measures. At baseline, on postoperative day 1, day 5, month 1, and month 3, data will be gathered.

Discussion: This study introduces an innovative rehabilitation approach that, to our knowledge, uniquely integrates preoperative blood flow restriction training with postoperative continuous passive motion in patients having total knee arthroplasty. This combined method aims to use the muscle-building benefits of BFR along with the movement-supporting benefits of CPM, which could lead to faster recovery and better strength improvement. If a short-term solution is effective, it will be more effectively implemented in hospitals.

Trial registration: The Ethics Committee of the Third Bethune Hospital of Jilin University accepted this study, with reference number (2024) Clinical Research Application No. 2024112815, on November 28, 2024. China Clinical Trial Registry (ChiCTR) ChiCTR2400094134. Registered on November 28, 2024.