Ischemia-reperfusion injury of the appendicular musculoskeletal system is when there is not enough blood getting to the bones and muscles in your arms and legs. When blood stops flowing, the muscles and bones don't get the energy and oxygen they need, so they can become damaged. When the blood supply is restored, the injured muscles and bones can be further damaged by a reaction called reperfusion injury. Reperfusion injury occurs when too much oxygen enters the muscles and bones in a short period of time, which can make the damage worse.