Castle Joshua P, Tramer Joseph S, Turner Elizabeth H G, Cotter Daniel, McGee Anna, Abbas Muhammad J, Gasparro Matthew A, Lynch T Sean, Moutzouros Vasilios
Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI, 48202, USA.
J Orthop. 2023 Mar 13;38:47-52. doi: 10.1016/j.jor.2023.03.007. eCollection 2023 Apr.
Blood flow restriction (BFR) therapy has demonstrated benefits across a spectrum of musculoskeletal injuries, including improved strength, endurance, function, and reduction in pain perception. There is, however, no standardized application of BFR therapy among orthopaedic surgeons within the United States (US).
The indication and protocol for BFR therapy vary significantly across providers in the US.
An online survey of 21 multiple-choice questions was sent to 3,281 surgeons listed on a large orthopaedic registry. A cross-sectional study was performed on all surgeons who successfully completed the questionnaire. Surgeons were queried on current or planned use of BFR, indications, contraindications, and peri-operative and non-operative management of sports-related injuries.
Overall, 250 physicians completed the survey, with 149 (59.8%) reporting current BFR use and 75.2% initiating use in the last 1-5 years. Most protocols (78.8%) utilize the modality 2-3 times per week while 15.9% use it only once weekly. Anterior cruciate ligament reconstruction (ACLR) rehabilitation was the most reported indication for initiating BFR therapy (95.7%) along with medial patellofemoral ligament reconstruction (70.2%), multiligamentous knee reconstruction (68.8%), meniscus repair (62.4%), collateral ligament reconstruction (50.4%), Achilles tendon repairs (30.5%), and meniscectomy (27%). Only 36.5% reported using BFR after upper extremity procedures, such as distal biceps repair (19.7%), ulnar collateral ligament elbow reconstruction (17%), rotator cuff (16.8%), and shoulder labrum repair (15.3%). For non-operative injuries, 65.8% of surgeons utilized BFR. Of those not currently using BFR therapy, 33.3% intended to implement its use in the future.
BFR therapy has increased in popularity with most physicians implementing its use in the last 5 years. BFR was commonly utilized after ACLR.
BFR allows light-load resistance to simulate high-intensity resistance training. This study describes US orthopaedic surgeons' common practice patterns and patient populations that utilize BFR therapy.
血流限制（BFR）疗法已在一系列肌肉骨骼损伤中显示出益处，包括增强力量、耐力、功能以及减轻疼痛感知。然而，在美国，骨科医生对BFR疗法的应用尚无标准化方案。
在美国，不同医疗服务提供者对BFR疗法的适应证和方案差异显著。
向一个大型骨科登记处列出的3281名外科医生发送了一份包含21个多项选择题的在线调查问卷。对所有成功完成问卷的外科医生进行了横断面研究。询问外科医生关于BFR的当前或计划使用情况、适应证、禁忌证以及与运动相关损伤的围手术期和非手术管理。
总体而言，250名医生完成了调查，其中149名（59.8%）报告当前正在使用BFR，75.2%在过去1至5年开始使用。大多数方案（78.8%）每周使用该方法2至3次，而15.9%仅每周使用一次。前交叉韧带重建（ACLR）康复是开始BFR疗法最常报告的适应证（95.7%），其次是内侧髌股韧带重建（70.2%）、多韧带膝关节重建（68.8%）、半月板修复（62.4%）、侧副韧带重建（50.4%）、跟腱修复（30.5%）和半月板切除术（27%）。只有36.5%的人报告在进行上肢手术后使用BFR，如肱二头肌远端修复（19.7%）、尺侧副韧带肘关节重建（17%）、肩袖修复（16.8%）和肩关节盂唇修复（15.3%）。对于非手术损伤，65.8%的外科医生使用BFR。在目前未使用BFR疗法的医生中，33.3%打算在未来采用该疗法。
BFR疗法在过去5年中越来越受欢迎，大多数医生都在使用。ACLR后通常会使用BFR。
BFR允许轻负荷阻力来模拟高强度阻力训练。本研究描述了美国骨科医生使用BFR疗法的常见实践模式和患者群体。
