Adductor Canal Block for Medial Compartment Knee Arthroplasty

Wake Forest University (WFU)

Status and phase: Completed; Phase 4

Conditions: Postoperative Analgesia; Medial Unicompartmental Knee Arthroplasty

Treatments: Drug: Lumbar plexus block; Drug: Adductor canal block

Study type: Interventional

Funder types: Other

Identifiers

NCT01818531

IRB00023002

Details and patient eligibility

About

This study will evaluate the affects of a single injection ultrasound-guided adductor canal block for patients undergoing robotic-assisted (MAKOplasty) medial UKA (unicompartmental knee arthroplasty). Specifically, this study will compare the adequacy of postoperative analgesia provided by the adductor canal block with that provided by single injection lumbar plexus blockade. The working hypothesis is that the analgesia provided by the adductor canal block will be equivalent to the analgesia provided by the lumbar plexus block. The primary outcome will be a comparison of verbal numerical pain scores at rest and with movement over the first 24 hours following nerve blockade.

Enrollment: 150 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged 18-85
• Undergoing unilateral robotic-assisted (MAKOplasty) medial compartment knee arthroplasty at Wake Forest University Baptist Medical Center.
• Must give written informed consent for anesthesia including subarachnoid blockade and peripheral nerve blockade of both the lumbar plexus and adductor canal.
• Must consent to the performance of a sham block at the site to which they are not randomized.
• Must also be reliable to give accurate verbal pain scores postoperatively.

Exclusion criteria

• Contraindication to adductor canal blockade or lumbar plexus blockade (including significant coagulation abnormalities)
• History of opioid addiction or current chronic pain therapy for pain other than at the surgical site that is being treated with high-dose opioids (extended release opioids or > 40mg oxycodone equivalents per day)
• Allergy to study medications
• Failure to adequately place either the adductor canal or lumbar plexus blocks.
• Patients who decline or have a contraindication to subarachnoid blockade will also be excluded from the study.
• Pregnancy.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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150 participants in 2 patient groups

Adductor canal block

Experimental group

Description:

Patients in this arm will receive an adductor canal block prior to undergoing a medial compartment knee arthroplasty.

Treatment:

Drug: Adductor canal block

Lumbar plexus block

Active Comparator group

Description:

Patients in this arm will receive a lumbar plexus block prior to undergoing a medial compartment knee arthroplasty.

Treatment:

Drug: Lumbar plexus block