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Blood Flow Restriction Enhances Recovery After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Gopinatth, Varun; Garcia, Jose R; Reid, Isabel K; Knapik, Derrick M; Verma, Nikhil N; Chahla, Jorge.
Afiliación
  • Gopinatth V; Saint Louis University School of Medicine, St. Louis, Missouri, U.S.A.
  • Garcia JR; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.
  • Reid IK; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.
  • Knapik DM; Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
  • Verma NN; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.
  • Chahla J; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: Jorge.chahla@rushortho.com.
Arthroscopy ; 2024 Jun 16.
Article en En | MEDLINE | ID: mdl-38889851
ABSTRACT

PURPOSE:

To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating neuromuscular and clinical outcomes of blood flow restriction (BFR) training after anterior cruciate ligament reconstruction (ACLR) compared with non-BFR rehabilitation protocols.

METHODS:

A systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic reviews and Meta Analyses guidelines by querying PubMed, MEDLINE, Scopus, the Cochrane Database for Systematic Review, and the Cochrane Central Register for Controlled Trials databases from inception through December 2023 to identify Level I and II RCTs evaluating outcomes of BFR training after ACLR compared with non-BFR rehabilitation. A meta-analysis was performed using random-effects models with standardized mean difference (SMD) for pain, muscle strength, and muscle volume, whereas mean difference was calculated for patient-reported outcome measures.

RESULTS:

Eight RCTs, consisting of 245 patients, met inclusion criteria, with 115 patients undergoing non-BFR rehabilitation compared with 130 patients undergoing BFR after ACLR. Mean patient age was 27.2 ± 6.7 years, with most patients being male (63.3%, n = 138/218). The length of the BFR rehabilitation protocol was most commonly between 8 and 12 weeks (range, 14 days to 16 weeks). Most studies set the limb/arterial occlusion pressure in the BFR group at 80%. When compared with non-BFR rehabilitation, BFR resulted in significant improvement in isokinetic muscle strength (SMD 0.77, P = .02, I2 58%), International Knee Documentation Committee score (mean difference 10.97, P ≤ .00001, I2 77%), and pain (SMD 1.52, P = .04, I2 87%), but not quadriceps muscle volume (SMD 0.28, P = .43, I2 76%).

CONCLUSIONS:

The use of BFR after ACLR led to improvements in pain, International Knee Documentation Committee score, and isokinetic muscle strength, with variable outcomes on the basis of quadriceps strength, volume, and thickness when compared with non-BFR rehabilitation. LEVEL OF EVIDENCE Level II, systematic review and meta-analysis of Level I and II studies.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Arthroscopy Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Arthroscopy Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos