Adductor Canal Block With or Without Biceps Femoris Short Head Block in Total Knee Arthroplasty

NCT07568106 | Not Yet Recruiting

• 1 other identifier: CU-BiFeS-2026
• Study Type: interventional
• Target: 132
• Locations: 1 country
• Sites: 1

Brief Summary

Total knee arthroplasty is associated with moderate to severe postoperative pain, which may delay mobilization and recovery. Multimodal analgesia including regional anesthesia techniques is widely used to improve outcomes. The adductor canal block (ACB) provides anteromedial knee analgesia but may not adequately cover the posterolateral region. The biceps femoris short head (BiFeS) block is a novel motor-sparing regional anesthesia technique targeting the posterolateral capsule of the knee. This randomized controlled trial aims to compare the analgesic efficacy and functional outcomes of ACB combined with BiFeS block versus ACB alone in patients undergoing total knee arthroplasty. The primary outcome is posterior knee pain at postoperative 6 hours. Secondary outcomes include pain scores within 48 hours, opioid consumption, early and late functional recovery, and opioid-related adverse effects.

Conditions

Total Knee Arthroplasty

Keywords

Total Knee Arthroplasty; Adductor Canal Block; Biceps Femoris Short Head Block; Postoperative Pain; Functional Recovery; Opioid Consumption; Knee Osteoarthritis

Outcome Measures

Primary Outcomes (1)

• Posterior Knee Pain Intensity

  Posterior knee pain assessed using the Numeric Rating Scale (NRS, 0-10), where 0 indicates no pain and 10 indicates worst imaginable pain.

  6 hours postoperatively

Secondary Outcomes (7)

• Postoperative Pain Intensity

  30 minutes, 1, 6, 12, 24, and 48 hours postoperatively

• Total Opioid Consumption

  0-48 hours postoperatively

• Rescue Analgesic Use

  0-48 hours postoperatively

• Functional Recovery

  24 hours, 48 hours, and 6 weeks postoperatively

• Quadriceps Muscle Strength

  Preoperatively, 24 hours, 48 hours, and 6 weeks postoperatively

Study Arms (2)

ACB + BiFeS

EXPERIMENTAL

Participants receive spinal anesthesia followed by an ultrasound-guided adductor canal block and a biceps femoris short head block using local anesthetic for postoperative analgesia.

Procedure: Adductor Canal Block; Procedure: Biceps Femoris Short Head Block

ACB + sham BiFeS

ACTIVE COMPARATOR

Participants receive spinal anesthesia followed by an ultrasound-guided adductor canal block and a sham biceps femoris short head block using normal saline.

Procedure: Adductor Canal Block; Procedure: Sham Biceps Femoris Short Head Block

Interventions

Adductor Canal Block PROCEDURE

Ultrasound-guided adductor canal block performed with injection of local anesthetic into the adductor canal to block the saphenous nerve and provide postoperative analgesia following total knee arthroplasty.

ACB + BiFeS; ACB + sham BiFeS

Biceps Femoris Short Head Block PROCEDURE

Ultrasound-guided biceps femoris short head block performed with injection of local anesthetic between the biceps femoris short head and femur to target the posterolateral innervation of the knee for postoperative analgesia.

ACB + BiFeS

Sham Biceps Femoris Short Head Block PROCEDURE

Sham ultrasound-guided biceps femoris short head block performed with injection of normal saline at the same anatomical location to maintain blinding without providing active analgesia.

ACB + sham BiFeS

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• ASA I-III
• Adult patients undergoing unilateral primary TKA
• Planned spinal anesthesia
• Written informed consent

You may not qualify if:

• Coagulopathy
• Drug allergy
• BMI \> 35
• Renal/hepatic failure
• Chronic pain or opioid use
• Depression or psychiatric disorder
• Revision or bilateral TKA
• Neurological deficits
• Preoperative ROM \< 90°

Sponsors & Collaborators

• Cukurova University: lead

Study Sites (1)

Cukurova University

Adana, Saricam, 01330, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative; Osteoarthritis, Knee

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Demet Lafli Tunay, M.D.

CONTACT

+905358685831; dlafli@yahoo.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Anesthesiology

Study Record Dates

• First Submitted: April 23, 2026
• First Posted: May 5, 2026
• Study Start (Estimated): May 15, 2026
• Primary Completion (Estimated): January 15, 2027
• Study Completion (Estimated): February 15, 2027
• Last Updated: May 5, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)