Femoral Versus Adductor Canal Continuous Peripheral Nerve Blocks for Knee Arthroplasty

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-12-31

Study Completion Date

2014-09-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Patients typically experience moderate-to-severe pain following knee arthroplasty that is usually treated with a combination of oral and intravenous analgesics and enhanced by continuous peripheral nerve blocks. There are currently two locations to place a perineural catheter to provide analgesia following knee arthroplasty: a femoral nerve catheter and an adductor canal catheter. Both have been demonstrated to be effective following knee arthroplasty. However, it remains unknown if one location is superior to the other; or, more accurately, what the relative benefits are to each technique.

While femoral CPNB has many benefits, one of the challenges of using this technique is that there is a decrease in quadriceps muscle strength which can be a limiting factor for rehabilitation. In contrast, the adductor canal catheter affects only the vastus medialis. This block may lessen block-induced quadriceps weakness following knee arthroplasty compared with a femoral infusion.

The investigators hypothesize that compared with femoral perineural local anesthetic infusion, an adductor canal infusion is associated with a shorter time until four discharge criteria are met: (1) adequate analgesia; (2) independence from intravenous analgesics; (3) ability to ambulate 30 m; and (4) ability to stand, walk 3 m, and return to a sitting position without another's assistance.

Related Clinical Trials

Explore similar clinical trials based on study characteristics and research focus.

Motor-Sparing Peripheral Nerve Blockade Facilitates Mobility Post Total Knee Arthroplasty: A Randomized Controlled Trial

NCT02773537

Arthroplasty, Replacement, Knee

COMPLETED NA

Continuous Adductor Canal Blocks Vs. Low Dose Femoral Nerve Blocks For Early Rehabilitation After Total Knee Arthroplasty

NCT02453321

Pain, Postoperative Total Knee Arthroplasty (TKA)

COMPLETED PHASE4

Epidural Catheter With or Without Adductor Canal Nerve Block for Postoperative Analgesia Following Total Knee Arthroplasty

NCT02121392

Arthroplasty, Replacement, Knee Nerve Block

COMPLETED NA

Ultrasound-guided Adductor Canal Block for Total Knee Replacement

NCT02100579

Complications; Arthroplasty Knee Injuries

COMPLETED PHASE4

Pain Control for Anterior Cruciate Ligament Reconstruction Patients With Adductor Canal or Femoral Perineural Infusions

NCT03208478

Pain, Postoperative Anterior Cruciate Ligament Injury

COMPLETED NA

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Of importance: The primary investigation involves 80 evaluable subjects (with primary endpoint data) having tri-compartment knee arthroplasty. In addition, the investigators will enroll up to 70 subjects having uni-compartment knee arthroplasty as a pilot study in preparation for a subsequent larger, definitive trial. These two groups will not be analyzed together--they represent two distinct studies: one a definitive RCT for tri-compartment knee arthroplasty; and, one a pilot study for uni-compartment knee arthroplasty.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Postoperative Pain Following Knee Arthroplasty

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Control

Femoral perineural local anesthetic infusion

Group Type ACTIVE_COMPARATOR

Control: Femoral perineural local anesthetic infusion

Intervention Type DRUG

The control group will receive a femoral nerve block and postoperative ropivacaine 0.2% infusion

Experimental

Adductor canal perineural local anesthetic infusion

Group Type EXPERIMENTAL

Experimental: Adductor Canal perineural local anesthetic infusion

Intervention Type DRUG

The control group will receive an adductor canal nerve block and postoperative ropivacaine 0.2% infusion

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Control: Femoral perineural local anesthetic infusion

The control group will receive a femoral nerve block and postoperative ropivacaine 0.2% infusion

Intervention Type DRUG

Experimental: Adductor Canal perineural local anesthetic infusion

The control group will receive an adductor canal nerve block and postoperative ropivacaine 0.2% infusion

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. primary, unilateral knee arthroplasty
2. age ≥ 18 years
3. postoperative analgesic plan includes perineural local anesthetic infusion of 48-72 hours

Exclusion Criteria

1. morbid obesity as defined by a body mass index \>40 (BMI=weight in kg/ \[height in meters\]
2. chronic, high-dose opioid use (greater than 20mg oxycodone-equivalent opioid use daily within the 2 weeks prior to surgery and duration of use \>4 weeks)
3. history of opioid abuse
4. allergy to study medications
5. known renal insufficiency (creatinine \> 1.5 mg/dL)
6. pregnancy
7. incarceration
8. any known neuro-muscular deficit of the ipsilateral femoral nerve, obturator nerve and/or quadriceps muscle (including diabetic peripheral neuropathy); and inability to ambulate 30 m preoperatively.

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No