Effect of Adding Vastus Medialis Nerve Block to Adductor Canal Block After Anterior Cruciate Ligament Reconstruction

NCT07683078 | Completed

• 1 other identifier: 681433
• Study Type: interventional
• Target: 104
• Locations: 1 country
• Sites: 1

Brief Summary

Anterior cruciate ligament (ACL) reconstruction is frequently associated with moderate to severe postoperative pain, which can delay mobilization and rehabilitation. The adductor canal block (ACB) is widely used for postoperative pain management because it provides effective analgesia while preserving quadriceps muscle strength. However, pain originating from the medial aspect of the knee may not be adequately controlled with ACB alone because the nerve to the vastus medialis may not be consistently anesthetized. This prospective randomized controlled trial evaluates whether adding a vastus medialis nerve block (VMNB) to a standard adductor canal block improves postoperative pain control in patients undergoing elective arthroscopic ACL reconstruction. Participants are randomly assigned to receive either ACB alone or ACB combined with VMNB before surgery, while all patients receive the same standardized general anesthesia, surgical technique, and postoperative analgesic regimen. The primary outcome is postoperative pain intensity measured using the Visual Analog Scale (VAS) at 1, 6, 12, and 24 hours after surgery. Secondary outcomes include postoperative opioid consumption, time to first mobilization, length of hospital stay, and block-related complications. The results of this study may help determine whether the addition of a vastus medialis nerve block provides clinically meaningful benefits and may contribute to improving postoperative pain management following ACL reconstruction.

Conditions

Anterior Cruciate Ligament Injury

Keywords

Anterior Cruciate Ligament Reconstruction; Adductor Canal Block; Vastus Medialis Nerve Block; Regional Anesthesia; Postoperative Pain

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Intensity

  Postoperative pain intensity will be assessed using the 10-cm Visual Analog Scale (VAS) at rest at 1, 6, 12, and 24 hours after surgery. VAS scores range from 0 (no pain) to 10 (worst imaginable pain).

  24 hours after surgery

Secondary Outcomes (3)

• Postoperative Opioid Consumption

  24 hours after surgery

• Time to First Mobilization

  24 hours after surgery

• Length of Hospital Stay

  24 hours after surgery

Study Arms (2)

Adductor Canal Block

ACTIVE COMPARATOR

Participants received an ultrasound-guided adductor canal block before elective arthroscopic anterior cruciate ligament reconstruction. All participants received standardized general anesthesia and postoperative analgesic management.

Procedure: Adductor Canal Block (ACB) Only

Adductor Canal Block Plus Vastus Medialis Nerve Block

ACTIVE COMPARATOR

Participants received an ultrasound-guided adductor canal block combined with an ultrasound-guided vastus medialis nerve block before elective arthroscopic anterior cruciate ligament reconstruction. All participants received standardized general anesthesia and postoperative analgesic management.

Procedure: Adductor Canal Block (ACB) Only; Procedure: Vastus Medialis Nerve Block

Interventions

Adductor Canal Block (ACB) Only PROCEDURE

An ultrasound-guided adductor canal block was performed before induction of general anesthesia using 15-20 mL of 0.25% bupivacaine as part of the multimodal analgesia protocol for anterior cruciate ligament reconstruction.

Adductor Canal Block; Adductor Canal Block Plus Vastus Medialis Nerve Block

Vastus Medialis Nerve Block PROCEDURE

An ultrasound-guided vastus medialis nerve block was performed before induction of general anesthesia using 5-10 mL of 0.25% bupivacaine in addition to the adductor canal block.

Adductor Canal Block Plus Vastus Medialis Nerve Block

Eligibility Criteria

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

You may qualify if:

• Adults aged 18 to 65 years.
• Scheduled for elective primary arthroscopic anterior cruciate ligament (ACL) reconstruction.
• American Society of Anesthesiologists (ASA) physical status I or II.
• Ability to provide written informed consent.

You may not qualify if:

• Previous surgery on the ipsilateral knee.
• Bilateral knee surgery.
• Coagulopathy or ongoing anticoagulant therapy contraindicating regional anesthesia.
• Peripheral neuropathy or neuromuscular disease.
• Local infection at the block injection site.
• Known allergy or hypersensitivity to amide local anesthetics.
• Contraindication to regional anesthesia.
• Refusal to participate in the study.

Sponsors & Collaborators

• Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization: lead

Study Sites (1)

SBU Bagcilar Education and Training Hospital

Istanbul, ABD Dışında, 34400, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries; Pain, Postoperative

Interventions

Single Person

Condition Hierarchy (Ancestors)

Knee Injuries; Leg Injuries; Wounds and Injuries; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Intervention Hierarchy (Ancestors)

Marital Status; Family Characteristics; Demography; Population Characteristics; Socioeconomic Factors

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Medical Doctor

Model Details: Participants were randomly assigned in a 1:1 ratio to receive either an adductor canal block alone or an adductor canal block combined with a vastus medialis nerve block before elective arthroscopic anterior cruciate ligament reconstruction. Both groups received standardized general anesthesia, perioperative care, and postoperative analgesic management.

Study Record Dates

• First Submitted: June 27, 2026
• First Posted: July 6, 2026
• Study Start: March 14, 2026
• Primary Completion: July 4, 2026
• Study Completion: July 11, 2026
• Last Updated: July 14, 2026

Record last verified: 2026-07

Locations

TU (1)