Blood Flow Restriction Therapy Following Achilles Tendon Repair in Male Patients

Objective: Our purpose is to assess the effectiveness of blood flow restriction therapy(BFRT) compared to a standard accelerated rehabilitation program following operative Achilles tendon repair.

Design: This is a retrospective, unblinded cohort study.

Setting: This study took place at a tertiary care institutional orthopaedic outpatient clinic.

Patients: All patients who underwent primary Achilles tendon repair between 2013 and 2020 by the senior author were included. Patients of female sex and age greater than 65 were excluded due to low numbers.Patients with chronic pathology, prior surgery, reconstructions, tendon transfers, or history of injury or surgery on the contralateral ankle or foot were also excluded.

Interventions: The primary outcome was calf circumference, measured at its approximate maximum diameter on the operative leg. Secondary outcomes include the presence of wound complications as well as any other postoperative complications. Those who underwent physical therapy with BFRT comprised the study group; those without BFRT were controls.
Main outcome measures: Calf circumference at widest point before and after both BFRT and standard physical therapy without BFRT.

Results: 19 patients receiving BFRT in addition to a standard accelerated rehabilitation program were compared to 89 patients undergoing astandard accelerated postoperative physical therapy program. Mean clinical follow-up was 9.3 months. There was a trend in patients undergoing BFRT to have a smaller difference in calf circumference at late term follow ups.However, this was not statistically significant.

Conclusions: BFRT may allow fora more robust return of calf girth following Achilles repair, compared to a standard accelerated rehabilitation program, however larger studies are needed.