Intra-Operative Adductor Canal Blocks

NCT ID: NCT05601427

Last Updated: 2025-04-25

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 80 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-03-22
• Study Completion Date: 2026-01-31

Brief Summary

Adductor canal blocks (ACB) have been recommended in total knee arthroplasty (TKA) to provide better control of post-operative pain, facilitate early ambulation, and reduce length of stay in the hospital. ACB is typically done before surgery by an anesthesiologist, which may increase time per case, cost, and requires the specialized skills of an anesthesiologist trained in regional anesthesia. Recent studies have suggested that surgeons can safely and reliably administer the adductor canal blocks (sACB) during surgery. However, there is currently very limited data on the clinical efficacy of such sACBs, and no studies assessing this technique in the context TKA that are discharged the same day. As such, this randomized control trial (RCT) is being done to compare sACBs to conventional anesthesiologist-performed adductor canal blocks (aACB).

Conditions

Knee Osteoarthritis; Knee Arthritis; Knee Pain Chronic; Anesthesia

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

Anesthesiologist-Performed Adductor Canal Block (aACB)

Patients will get a pre-operative adductor canal block performed by an anesthesiologist.

Group Type: ACTIVE_COMPARATOR

aACB

Intervention Type: PROCEDURE

The patient will undergo a pre-operative single-shot, ultrasound-guided ACB performed by an anaesthesiologist skilled in regional anaesthesia techniques. The ACB will be performed in a dedicated block room, immediately prior to administration of a spinal anaesthetic.

Surgeon-Performed Adductor Canal Block (sACB)

Patients will get an intra-operative adductor canal block performed by the surgeon

Group Type: EXPERIMENTAL

sACB

Intervention Type: PROCEDURE

The patient will undergo an intraoperative single-shot ACB performed by the treating surgeon following placement of the TKA components.

Interventions

aACB

The patient will undergo a pre-operative single-shot, ultrasound-guided ACB performed by an anaesthesiologist skilled in regional anaesthesia techniques. The ACB will be performed in a dedicated block room, immediately prior to administration of a spinal anaesthetic.

Intervention Type: PROCEDURE

sACB

The patient will undergo an intraoperative single-shot ACB performed by the treating surgeon following placement of the TKA components.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

1. Male and female patients aged 18 years or older

2. Primary TKA booked as SDD

3. Diagnosis of osteoarthritis

Exclusion Criteria

1. Inability or refusal to sign informed consent form

2. Non-English or French speaking, and no licensed translator, family member or substitute decision maker available.

3. Non-osteoarthritis primary diagnosis

4. Allergy to analgesic medications

5. Contraindication to spinal and/or regional anaesthesia

6. Any use of opioid pain medication within four weeks of the index procedure(13)

7. Pain catastrophizing scale score ≥16 (8, 9, 14)

8. History of cirrhosis

9. History renal insufficiency

10. History or sensory and/or motor neuropathy to the ipsilateral limb

11. Simultaneous, bilateral TKA

12. Non-TKA prosthesis

13. Scheduled for non-SDD TKA.

14. Preoperative varus/valgus of >10 degrees.

15. Planned General Anaesthetic

16. Use of Intrathecal Morphine

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Canadian Orthopaedic Foundation

OTHER

Sponsor Role: collaborator

Ottawa Hospital Research Institute

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Simon Garceau, MD

Role: PRINCIPAL_INVESTIGATOR

The Ottawa Hospital

Locations

The Ottawa Hospital

Ottawa, Ontario, Canada

Site Status: RECRUITING

Countries

Canada

Central Contacts

Sanjula Costa

Role: CONTACT

scosta@ohri.ca

613-737-8899 ext. 72640

Facility Contacts

Sanjula Costa

Role: primary

scosta@ohri.ca

613-737-8899 ext. 72640

Other Identifiers

20220573-01H

Identifier Type: -

Identifier Source: org_study_id