Table 1 Characteristics of articles included in the meta-analysis
Author | Year | Country | Study design | Age (BFRT vs. Control, years ± SD) | Number (BFRT vs. Control) | Baseline Characteristics (Height/Weight/BMI, BFRT group) | Baseline Characteristics (Height/Weight/BMI, Control group) | Graft Origin | Occlusion Tool (Cuff Width) | Concomitant Surgical Procedures | Occlusion Area | Pressure Level | Intervention Duration | Comparison Group | Exercise | Frequency | Total time | Duration |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Iversen et al. | 2016 | Norway | RCT | 24.9 ± 7.4 vs. 29.8 ± 9.3 | 12 vs. 12 | 176.9 ± 7.9/76.9 ± 12.1/NA | 178.9 ± 7.8/77.6 ± 9.6/NA | hamstring tendon graft (HS) | Delfi low pressure cuff (14 cm width) | / | most proximal part of the thigh | 130-180mmHg | day 2–14 after surgery | non-BFR | Isometric quadriceps contractions, leg extension over a knee-roll, straight leg-raises | 2/day | 12 days | restriction of blood flow 5 min, 5 groups and 20 repetitions per group |
Zargi et al. | 2016 | Slovenia | Quasi-RCT | 33 ± 7 vs. 34 ± 10 | 10 vs. 10 | NA/NA/23.7 ± 3.1 | NA/NA/23.5 ± 3.9 | semitendinosus-gracilis autograft | VariFit Conture Thigh Cuff (14 cm width) | 12 meniscectomy | most proximal part of the thigh | 150 mmHg | 10 days before surgery | sham-BFR at 20 mmHg | unilateral resisted knee extension | 3/week | 9 days | restriction of blood flow, 6 groups and 40 repetitions per group |
Zargi et al. | 2018 | Slovenia | Quasi-RCT | 34 ± 6 vs. 35 ± 5 | 10 vs. 10 | NA/NA/24.3 ± 3.9 | NA/NA/23.9 ± 2.9 | semitendinosus-gracilis autograft | VariFit Conture Thigh Cuffs(14 cm width) | 12 meniscectomy | most proximal part of the thigh | 150 mmHg | 8 days before surgery | sham-BFR at 20 mmHg | unilateral resisted knee extension | 3/week | 1 week | restriction of blood flow, 6 groups and 40 repetitions per group |
Takarada et al. | 2000 | Japan | RCT | 22.4 ± 2.1 vs. 23 ± 2.5 | 8 vs. 8 | NA/NA/NA | NA/NA/NA | / | Pneumatic occlusion cuff(90 mm width) | / | most proximal part of the thigh | 200–260 mmHg | 3 days before surgery | placebo occlusion | / | 2/day | 2 weeks | restriction of blood flow for 5 min, 5 groups of exercise |
Kacin et al. | 2021 | Slovenia | Quasi-RCT | 38 ± 6 vs. 38 ± 8 | 6 vs. 6 | NA/NA/26.0 ± 4.9 | NA/NA/ 25.8 ± 5.4 | semitendinosus-gracilis autograft | Ischemic Trainer double-chamber cuff (13.5 cm width) | / | most proximal part of the thigh | 150 mmHg | before surgery | sham-BFR at 20 mmHg | Knee flexion and extension of the injured leg. | 3/week | 3 weeks | restriction of blood flow, 4 groups and 40 repetitions per group |
Jung et al. | 2022 | Korea | Quasi-RCT | 30.83 ± 7.59 vs. 27.83 ± 8.43 | 12 vs. 12 | 170.27 ± 8.80/78.68 ± 18.63/NA | 172.58 ± 4.76/71.98 ± 10.05/NA | / | Smart Tool Plus single-chamber pneumatic cuff | / | most proximal part of the thigh | 40% systolic blood pressure | 3 days after surgery | non-BFR | enhance range of motion (ROM exercise), weight-bearing exercise, closed kinetic chain (CKC) exercise and open kinetic chain (OKC) exercise | 3/week | 12 weeks | restriction of blood flow, Four sets of exercises and with each set resting for 30 s, totaling 75 times |
Li et al. | 2023 | China | RCT | 30.50 ± 5.26 vs. 28.33 ± 5.19 | 8 vs. 6 | 175.87 ± 11.06/79.13 ± 12.78/NA | 172.33 ± 12.56/74.67 ± 23.09/NA | / | AirBands | / | proximal thigh | 80% Arterial occlusion pressure | > 8 weeks after surgery | non-BFR | elastic band, yoga ball, self-weight lunge squat, up and down stairsnge squat, resistance squat, single-leg Bulgarian squat, resistance lunge walk, Thera-Band USA elastic bands, utilized red ones. | 2/week | 8 weeks | restriction of blood flow, Four sets of exercises and with each set resting for 30 s, totaling 75 times |
Jack II et al. | 2022 | USA | RCT | 28.1 ± 7.4 vs. 24.1 ± 7.2 | 17 vs. 15 | 173.6 ± 9.2/76.6 ± 15.5/25.2 ± 2.8 | 170.9 ± 12.4/79.3 ± 22.0/26.9 ± 5.3 | bone-patellar tendon-bone (BPTB) | Delfi Medical | / | most proximal part of the thigh | 80% arterial limb occlusion pressure | 7 days after surgery | non-BFR | Quadriceps Contractions, Closed-chain Knee Extensions, Bilateral Leg Press, Single Leg Press, Single Leg Hamstring Curl, Ball Squats, Split Lunges, Box Step-ups | 2/week | 12 weeks | restriction of blood flow, Four sets of exercises and with each set resting for 30 s, totaling 75 times |
De Melo et al. | 2022 | Brazil | RCT | 41.1 ± 9.8 vs. 39.6 ± 10.8 | 12 vs. 12 | 173.1 ± 7.6/73.1 ± 13.9/24.2 ± 3.0 | 170.2 ± 6.2/68.6 ± 10.4/23.6 ± 2.4 | / | Cuff Scientific Leg®–WCS | / | most proximal part of the thigh | 80% arterial limb occlusion pressure | 3 days after surgery | non-BFR | Leg press, Flexor chair | 2/week | 12 weeks | restriction of blood flow, Four sets of exercises and with each set resting for 30 s, totaling 75 times |
Ohta et al. | 2003 | Japan | RCT | 28 ± 9.7 vs. 30 ± 9.7 | 22 vs. 22 | NA/65 ± 14/NA | NA/63 ± 8.8/NA | semitendinosus–gracilis tendon | Hand-pumped tourniquet | / | proximal part of the thigh | 180 mmHg | 2 weeks after surgery | non-BFR | Straight leg raising, hip joint abduction, Half-squat, Step-up, Elastic tube, Knee-bending walking | 6/week | 14 weeks | restriction of blood flow, 1–3 groups and 20 repetitions per group |
Okoroha et al. | 2023 | USA | RCT | 25.4 ± 10.6 vs. 27.5 ± 12 | 22 vs. 24 | NA/NA/24.9 ± 3.1 | NA/NA/26.9 ± 5.3 | 30 BPTB,13 HS,3 quadriceps tendon autograft | Single-chamber pneumatic torniquet (Smart Tool Plus) | 9 meniscal repair,18 meniscectomy | most proximal part of the thigh | 80% limb occlusion pressure | 2 weeks before surgery | non-BFR | quadriceps contractions in end-range extension, straight-leg raises, long-arc quadriceps sets, and quarter squats. | 5/week | 14 weeks | restriction of blood flow, Four sets of exercises and with each set resting for 30 s, totaling 75 times |