A Comparative Study of Combined Adductor Canal and Interspace Between Popliteal Artery and Knee Capsule Versus Combined Adductor Canal and Genicular Nerve in Total Knee Arthroplasty
1 other identifier
interventional
70
1 country
1
Brief Summary
The aim of this study is to investigate the effectiveness of combined adductor canal block (ACB) with interspace between popliteal artery and the knee capsule (IPACK) versus combined ACB with genicular nerve block (GNB) for providing analgesia in knee arthroplasty. The investigators hypothesize that the analgesic efficacy of ACB combined with GNB will be non-inferior to that of ACB combined with IPACK. Additionally, the investigators aim to assess whether the combination of ACB and GNB results in a significantly lower occurrence of sensory or motor block affecting the tibial and common peroneal nerves compared to ACB and IPACK
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable
Started Mar 2025
Shorter than P25 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
February 21, 2025
CompletedFirst Posted
Study publicly available on registry
March 7, 2025
CompletedStudy Start
First participant enrolled
March 15, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
September 30, 2025
CompletedStudy Completion
Last participant's last visit for all outcomes
October 15, 2025
CompletedMarch 7, 2025
January 1, 2025
7 months
February 21, 2025
March 6, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
individual visual analog pain scores at 0, 6, 12 , 24 and 48 h postoperatively
(VAS; 0 = no pain and 10 = worst pain imaginable)
48 hours
Secondary Outcomes (5)
time to first reported pain and first analgesic request during post-anesthesia care unit stay
48 hours
Analgesic consumption during the first 48 h post-surgery
48 hours
Quadriceps muscle strength
24 hours
The sensorimotor functions of the tibial nerve and common peroneal nerve (CPN) will be evaluated using a 3-point scale
8 hours postoperative
Ambulation and mobilization ability
48 hours
Study Arms (2)
Patients receiving combined ACB and IPACK blocks
ACTIVE COMPARATORultrasound guided block of saphenous nerve in adductor canal and block of articular branches of knee between the popliteal artery and the knee capsule (IPACK)
Patients receiving combined ACB and GNB
ACTIVE COMPARATORultrasound guided block of saphenous nerve in adductor canal and block of the three peri-knee nerve branches: the superior medial genicular nerve (SMGN), inferior medial genicular nerve (IMGN), and superior lateral genicular nerve (SLGN)
Interventions
ultrasound guided adductor canal block and interspace between the popliteal artery and the knee capsule using bupivacaine 0.25%
Eligibility Criteria
You may qualify if:
- Patients American Society of anesthesiologists' physical status (ASA) I to III.
- Aged 18 to 70 years.
- Both sexes.
- Patients scheduled for total knee arthroplasty.
You may not qualify if:
- Patient refusal
- ASA physical status IV or more.
- Patients with known allergy to any of the study drugs.
- Infection at the site of injection.
- Patients with neuromuscular disease.
- Presence of any coagulopathy.
- Patients with history of any psychiatric or cognitive disorder.
- patient with previous knee surgery.
- BMI more than 40 kg/m2.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Ain Shams University
Cairo, Egypt
Related Publications (4)
Kukreja P, Venter A, Mason L, Kofskey AM, Northern T, Naranje S, Ghanem E, Lawson PA, Kalagara H. Comparison of Genicular Nerve Block in Combination With Adductor Canal Block in Both Primary and Revision Total Knee Arthroplasty: A Retrospective Case Series. Cureus. 2021 Jul 29;13(7):e16712. doi: 10.7759/cureus.16712. eCollection 2021 Jul.
PMID: 34471571BACKGROUNDPadhy S, Patki AY, Kar AK, Durga P, Sireesha L. Comparison of sensory posterior articular nerves of the knee (SPANK) block versus infiltration between the popliteal artery and the capsule of the knee (IPACK) block when added to adductor canal block for pain control and knee rehabilitation after total knee arthroplasty---A prospective randomised trial. Indian J Anaesth. 2021 Nov;65(11):792-797. doi: 10.4103/ija.ija_682_21. Epub 2021 Nov 23.
PMID: 35001951BACKGROUNDGonzalez Sotelo V, Macule F, Minguell J, Berge R, Franco C, Sala-Blanch X. Ultrasound-guided genicular nerve block for pain control after total knee replacement: Preliminary case series and technical note. Rev Esp Anestesiol Reanim. 2017 Dec;64(10):568-576. doi: 10.1016/j.redar.2017.04.001. Epub 2017 May 26. English, Spanish.
PMID: 28554709BACKGROUNDMu T, Yuan B, Wei K, Yang Q. Adductor canal block combined with genicular nerve block versus local infiltration analgesia for total knee arthroplasty: a randomized noninferiority trial. J Orthop Surg Res. 2024 Sep 6;19(1):546. doi: 10.1186/s13018-024-05048-5.
PMID: 39238029BACKGROUND
Related Links
MeSH Terms
Interventions
Intervention Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- PARTICIPANT
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
February 21, 2025
First Posted
March 7, 2025
Study Start
March 15, 2025
Primary Completion
September 30, 2025
Study Completion
October 15, 2025
Last Updated
March 7, 2025
Record last verified: 2025-01
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, CSR
- Time Frame
- from 20/2/2025 to 20/9/2025
- Access Criteria
- All researchers