Preoperative Blood Flow Restriction Training Combined with Postoperative Continuous Passive Motion in Elderly Patients After Total Knee Arthroplasty: Study Protocol  for a Randomized Controlled Trial

Background Total knee arthroplasty (TKA) is a widely practised surgical intervention for treating knee joint diseases,and postoperative rehabilitation is crucial for functional recovery.Blood flow restriction training,a novel rehabilitation approach,enhances muscle strength and endurance by restricting local blood flow.In recent years,BFR has gained increasing attention in the rehabilitation following TKA.The present research endeavours to evaluate the effectiveness of preoperative BFR training combined with postoperative continuous passive motion (CPM) on rehabilitation outcomes in TKA patients. Methods This research is a randomized controlled experiment involving 160 TKA patients,who will be randomly assigned to either the joint intervention group or the CPM group,with 80 participants in each group. All patients will receive routine care preoperatively. The intervention group will additionally receive preoperative BFR training and postoperative CPM therapy, Whereas the control group will only receive postoperative CPM therapy.The primary outcome measures, include the joint range of motion(ROM), visual analog scale(VAS) score,HSS score,and activities of daily living(ADL)score. The secondary outcomes included postoperative swelling(knee joint circumference change),C-reactive protein (CRP) levels,and performance of the 30-second chair stand test(30s-CST).Data will be collected at baseline,postoperative day 1,day 7,month 1,and month 3. Discussion This study presents a new idea for postoperative rehabilitation of patients undergoing total knee arthroplasty, which is expected to significantly improve their rehabilitation outcomes.If a short-term intervention can also have a good effect, this intervention will be better utilized in hospitals. Trial registration : This study was approved by the Ethics Committee of the hospital under the following number: (2024) Clinical Research Application No. (2024112815). It was also registered in the China Clinical Trial Registry with the trial registration number ChiCTR2400094134.