Intra-Operative Adductor Canal Blocks

NCT05601427 | Recruiting

• 1 other identifier: 20220573-01H
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

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

Outcome Measures

Primary Outcomes (2)

• Patient Report Pain

  Mean Numerical Pain Rating Scale (NPRS) scores on discharge

  Up to 24 hours

• Pain medication use

  morphine equivalents of pain medication

  When spinal anesthesia resolves until 24 hours after surgery

Secondary Outcomes (8)

• Time to discharge

  From PACU to discharge

• Admission to Hospital

  Up to 24 hours post-operative

• Readmission Rate

  Up to 24 hours post-operative

• Timed Up and Go Test

  At discharge

• Patient Reported Quality of Recovery

  At 24 hours post-operative

Study Arms (2)

Anesthesiologist-Performed Adductor Canal Block (aACB)

ACTIVE COMPARATOR

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

Procedure: aACB

Surgeon-Performed Adductor Canal Block (sACB)

EXPERIMENTAL

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

Procedure: sACB

Interventions

aACB 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.

Anesthesiologist-Performed Adductor Canal Block (aACB)

sACB PROCEDURE

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

Surgeon-Performed Adductor Canal Block (sACB)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Male and female patients aged 18 years or older
• Primary TKA booked as SDD
• Diagnosis of osteoarthritis

You may not qualify if:

• Inability or refusal to sign informed consent form
• Non-English or French speaking, and no licensed translator, family member or substitute decision maker available.
• Non-osteoarthritis primary diagnosis
• Allergy to analgesic medications
• Contraindication to spinal and/or regional anaesthesia
• Any use of opioid pain medication within four weeks of the index procedure(13)
• Pain catastrophizing scale score ≥16 (8, 9, 14)
• History of cirrhosis
• History renal insufficiency
• History or sensory and/or motor neuropathy to the ipsilateral limb
• Simultaneous, bilateral TKA
• Non-TKA prosthesis
• Scheduled for non-SDD TKA.
• Preoperative varus/valgus of \>10 degrees.
• Planned General Anaesthetic

Sponsors & Collaborators

• Ottawa Hospital Research Institute: lead
• Canadian Orthopaedic Foundation: collaborator

Study Sites (1)

The Ottawa Hospital

Ottawa, Ontario, Canada

RECRUITING

MeSH Terms

Conditions

Osteoarthritis, Knee

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Study Officials

• Simon Garceau, MD

  The Ottawa Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sanjula Costa

CONTACT

613-737-8899; scosta@ohri.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 20, 2022
• First Posted: November 1, 2022
• Study Start: March 22, 2023
• Primary Completion: December 1, 2025
• Study Completion: January 1, 2026
• Last Updated: April 25, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)