Adductor Canal Block Methods in Bilateral Total Knee Arthroplasty

NCT07506629 | Not Yet Recruiting

• 1 other identifier: 4-2026-0060
• Study Type: interventional
• Target: 48
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study aims to compare the analgesic efficacy of surgeon-performed intraoperative adductor canal block (ACB) and ultrasound-guided anesthesiologist-performed ACB in patients undergoing bilateral total knee arthroplasty (TKA). In a prospective, randomized paired design, each patient will receive surgeon-performed ACB on one knee and anesthesiologist-performed ACB on the contralateral knee. The primary outcome is postoperative pain measured using the Numeric Rating Scale (NRS), and the study is designed to evaluate the non-inferiority of surgeon-performed ACB. Secondary outcomes include opioid consumption, time to first ambulation, length of hospital stay, postoperative complications, and patient-reported outcome measures (PROMs). Additionally, postoperative ultrasound evaluation will be performed to assess the distribution pattern of local anesthetic within the adductor canal, including cross-sectional area and longitudinal spread. This study is expected to provide evidence regarding the clinical effectiveness and technical accuracy of surgeon-performed ACB in comparison with the conventional ultrasound-guided technique.

Conditions

Knee Osteoarthritis; Total Knee Arthroplasty; Postoperative Pain; Peripheral Nerve Block; Adductor Canal Block

Outcome Measures

Primary Outcomes (1)

• Pain (Numeric Rating Scale)

  Postoperative pain will be assessed using the Numeric Rating Scale (NRS, 0-10). Pain scores will be recorded at predefined time points under resting conditions. The primary analysis will evaluate the non-inferiority of surgeon-performed adductor canal block compared to ultrasound-guided adductor canal block.

  Baseline, postoperative day 0 (afternoon), postoperative day 1 (morning and afternoon), and postoperative day 2 (morning)

Study Arms (2)

Surgeon-Performed Adductor Canal Block

EXPERIMENTAL

Adductor canal block performed intraoperatively by the surgeon using an anatomical landmark-based technique. The injection is administered during surgery without ultrasound guidance using a standardized approach and the same type and volume of local anesthetic as the comparator.

Biological: Surgeon-Performed Adductor Canal Block

Ultrasound-Guided Adductor Canal Block

ACTIVE COMPARATOR

Adductor canal block performed by an anesthesiologist under ultrasound guidance using real-time imaging. The same concentration and volume of local anesthetic are administered using a standardized ultrasound-guided technique.

Biological: Ultrasound-Guided Adductor Canal Block

Interventions

Surgeon-Performed Adductor Canal Block BIOLOGICAL

An adductor canal block performed intraoperatively by the surgeon using an anatomical landmark-based technique. The injection is administered at approximately 8 cm proximal to the distal femur, with the needle directed medially and posteriorly. A total of 20 mL of 0.3% ropivacaine mixed with epinephrine is injected using a standardized approach without ultrasound guidance.

Surgeon-Performed Adductor Canal Block

Ultrasound-Guided Adductor Canal Block BIOLOGICAL

An adductor canal block performed by an anesthesiologist under ultrasound guidance. The saphenous nerve and femoral artery within the adductor canal are identified using real-time imaging, and 20 mL of 0.3% ropivacaine mixed with epinephrine is injected using an in-plane technique.

Ultrasound-Guided Adductor Canal Block

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult patients aged 19 years or older
• Patients scheduled for bilateral total knee arthroplasty
• Patients who provide written informed consent

You may not qualify if:

• Refusal to participate or inability to provide informed consent
• Neurological or psychiatric conditions affecting cooperation (e.g., dementia, delirium)
• Pre-existing neurological or anatomical abnormalities of the lower extremities
• Chronic opioid use or opioid dependence
• Coagulation disorders or contraindications to nerve block
• Pregnancy
• Cases in which ultrasound evaluation is technically not feasible

Sponsors & Collaborators

• Yonsei University: lead

MeSH Terms

Conditions

Osteoarthritis, Knee; Pain, Postoperative

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Central Study Contacts

Kwan-Kyu Park, Professor

CONTACT

+82-2-2228-2183; kkpark@yuhs.ac

Study Design

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

Study Record Dates

• First Submitted: March 26, 2026
• First Posted: April 1, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): January 1, 2029
• Study Completion (Estimated): March 1, 2029
• Last Updated: April 1, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share