Khalifa AA, Soliman WS. Blood flow restriction training in rehabilitation for knee conditions and elective knee procedures. World J Transl Med 2026; 12(2): 121778 [DOI: 10.5528/wjtm.121778]
Corresponding Author of This Article
Ahmed A Khalifa, MD, FRCS, Assistant Professor, Department of Orthopaedic, Qena Faculty of Medicine and University Hospital, South Valley University, Kilo 6 Qena-Safaga Highway, Qena 83523, Qina, Egypt. ahmed_adel0391@med.svu.edu.eg
Research Domain of This Article
Rehabilitation
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review-article
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Khalifa AA, Soliman WS. Blood flow restriction training in rehabilitation for knee conditions and elective knee procedures. World J Transl Med 2026; 12(2): 121778 [DOI: 10.5528/wjtm.121778]
World J Transl Med. Jul 28, 2026; 12(2): 121778 Published online Jul 28, 2026. doi: 10.5528/wjtm.121778
Blood flow restriction training in rehabilitation for knee conditions and elective knee procedures
Ahmed A Khalifa, Wafaa S Soliman
Ahmed A Khalifa, Department of Orthopaedic, Qena Faculty of Medicine and University Hospital, South Valley University, Qena 83523, Qina, Egypt
Ahmed A Khalifa, Department of Orthopaedic, Aster Sanad Hospital, Riyadh 13216, Riyadh, Saudi Arabia
Wafaa S Soliman, Department of Cardiology, Al-Jazeera Hospital, Riyadh 13216, Riyadh, Saudi Arabia
Author contributions: Khalifa AA conceived and designed the study and performed critical revisions; Khalifa AA and Soliman WS performed the literature search, data acquisition, and prepared the manuscript draft; both authors read, discussed, and approved the final manuscript.
AI contribution statement: No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Ahmed A Khalifa, MD, FRCS, Assistant Professor, Department of Orthopaedic, Qena Faculty of Medicine and University Hospital, South Valley University, Kilo 6 Qena-Safaga Highway, Qena 83523, Qina, Egypt. ahmed_adel0391@med.svu.edu.eg
Received: April 1, 2026 Revised: May 13, 2026 Accepted: June 8, 2026 Published online: July 28, 2026 Processing time: 119 Days and 12.5 Hours
Abstract
Rehabilitation protocols for various knee conditions and elective procedures are essential for restoring function and patient satisfaction, as these conditions are frequently associated with significant muscle strength loss and may eventually require prolonged recovery. This minireview highlights the adjunctive role of blood flow restriction (BFR) training in this context. The fundamental principles of BFR involve controlled external occlusion to induce physiological training effects with substantially reduced mechanical load. BFR was added to various rehabilitation protocols for patients with knee conditions, such as primary osteoarthritis and rheumatoid arthritis, and was also applied during the rehabilitation of patients undergoing knee-related surgical interventions, including anterior cruciate ligament reconstruction and total knee arthroplasty. Various studies, systematic reviews, and meta-analyses have shown the effectiveness of BFR in improving muscle strength and function, with added value for functional outcomes and patient satisfaction. Furthermore, it showed an acceptable safety profile. However, a clear description of the protocols for BFR, tailored to each patient and procedure, should be provided. Moreover, long-term data on BFR involvement in the rehabilitation protocols for different knee conditions and after various surgical procedures, compared with conventional rehabilitation protocols, are still required.
Core Tip: Rehabilitation is a crucial step in the conservative management of various knee conditions, including osteoarthritis and rheumatoid arthritis. Furthermore, it is a crucial step in the pre- and postoperative protocols for various elective knee joint surgical procedures, such as total knee arthroplasty and anterior cruciate ligament reconstruction. Blood flow restriction was introduced as an adjuvant to these rehabilitation protocols, demonstrating efficacy in improving muscle strength and performance, ultimately leading to improved function and quality-of-life outcomes. However, detailed descriptions and precise protocols for each condition supported by well-designed studies are still lacking.
