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N. Dierkes1, M. Moran1
1Marymount University, Physical Therapy, Arlington, VA, United States
Background: Repair of a focal defect in the articular cartilage of the knee is often done by an allograft osteochondral articular transfer (OAT) procedure. As is the case with other knee surgeries and with non-weightbearing restrictions, quadricep atrophy may develop after an OAT procedure. In recent years, low-load (20-40% 1 rep max) blood flow restriction (BFR) therapy has become one of the leading treatments to help load-compromised populations gain strength and hypertrophy after surgery. No research currently exists examining the use of BFR after an OAT procedure.
Purpose: The purpose of this case study is to describe the use of BFR therapy and exercise on the quadricep muscle, in a 40-year-old female status-post left knee OAT procedure, resulting in improved strength, hypertrophy, and function.
Methods: This case study details the use of BRF over 8 weeks. The patient performed three different BFR exercises one to two times each week. Exercises were given by the treating physical therapist and were based off the protocol given by the referring physician, focusing primarily on quadricep and hip strengthening.
Results: Improvements in both quadricep strength and hypertrophy were seen following an eight-week course of physical therapy incorporating blood flow restriction therapy and exercise. Strength was measured using a MicroFET 2 Dynamometer and manual muscle testing. Hypertrophy was evaluated by thigh girth measurements. The patient had a 70% increase in strength and a 3.5% change in thigh girth. In addition, she had an increase in Lower Extremity Functional Scale (LEFS) and Focus on Therapeutic Outcomes (FOTO) scores and increased self-reported functional mobility.
Conclusion(s): The results of this study show that blood flow restriction therapy may be a useful adjunct to traditional physical therapy to improve strength and hypertrophy of the quadricep after an OAT procedure.
Implications: Based on the observational findings, a clinical controlled study would be warranted to compare the effects of BFR against conventional therapeutic treatment.
Funding, acknowledgements: This work was unfunded.
Keywords: BFR, OAT procedure, therapeutic exercise
Topic: Orthopaedics
Did this work require ethics approval? No
Institution: Marymount University
Committee: IRB
Reason: IRB approval not required secondary to having patient consent and this being a case report.
All authors, affiliations and abstracts have been published as submitted.
