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

Abstract

OBJECTIVE: To summarize current protocols and outcome measures used in blood flow restriction training (BFRT) after orthopedic 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 orthopedic procedures and that reported function-based and patient-reported outcome measures. DATA SYNTHESIS: Qualitative synthesis was performed to identify current BFRT protocols used following orthopedic procedures, and the function-based and patient-reported outcomes reported. Studies were categorized by procedure type; outcomes were presented according to the frequency of reporting. RESULTS: Thirty studies (831 patients) were included. The use of BFRT was most frequently studied after anterior cruciate ligament 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 BFRT after ankle ORIF, high tibial osteotomy, total knee arthroplasty, shoulder stabilization, and distal biceps repair. BFRT was initiated within 2 weeks postoperatively 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. JOSPT Open 2026;4(2):155-165. Epub 19 February 2026. doi:10.2519/ josptopen.2026.0176.