Enhanced Recovery After Surgery (ERAS) Total Knee Replacement (TKR) with a Transitional Pain Service (EKAT-TeleTPS)

Hospital for Special Surgery (HSS)

Status: Enrolling

Conditions: Anesthesia

Treatments: Device: Continuous Adductor Canal Catheter (ACC); Device: Adductor Canal block with sham catheter

Study type: Interventional

Funder types: Other

Identifiers

NCT03747146

2017-1858

Details and patient eligibility

About

A comparison of two anesthetic techniques for total knee replacements: (1) Peri-Articular Injection (PAI), local infiltration between the popliteal artery and capsule of the knee block (IPACK) and single-shot adductor canal block (ACB) vs. (2) PAI, IPACK and continuous adductor canal block catheter (ACC).

Full description

Patients will be randomized to one of two groups: one group will receive a PAI, IPACK and single-shot adductor canal block; one group will receive PAI, IPACK and continuous adductor canal block catheter.

Enrollment: 94 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients with osteoarthritis scheduled for a primary total knee arthroplasty with a participating surgeon
• Planned use of regional anesthesia
• Ability to follow study protocol
• English speaking (secondary outcomes include questionnaires validated in English only)
• Lives within one hour of the hospital
• Has a smart phone

Exclusion criteria

• Hepatic or renal insufficiency
• Younger than 18 years old or older than 65 years ol
• Patients undergoing general anesthesia
• Allergy or intolerance to one of the study medications
• BMI >40
• Diabetes
• American Society of Anesthesiologists (ASA) status III or IV
• Chronic gabapentin/pregabalin use (regular use for longer than 3 months)
• Patients with chronic pain (from a referral to chronic pain service) or a pain catastrophizing scale (PCS >30)
• Patients with severe valgus deformity or flexion contracture
• Patients unable to follow home catheter instructions and unwilling to go home with an infusing catheter
• Patients who have no home caregivers in the event that a catheter is to be sent home with the patient
• Patients with planned stay at rehab facility (to avoid medical device being tampered with at the rehab facility)
• Non-English speakers (secondary outcomes include questionnaires validated in English only)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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94 participants in 2 patient groups

Continuous Adductor Canal Catheter (ACC)

Active Comparator group

Description:

Patients will receive a combined spinal epidural, PAI, IPACK, and a continuous adductor canal catheter

Treatment:

Device: Continuous Adductor Canal Catheter (ACC)

Adductor Canal block with sham catheter

Sham Comparator group

Description:

Patients will receive a combined spinal epidural, PAI, IPACK, and an adductor canal block. The patient will also receive a sham catheter.

Treatment:

Device: Adductor Canal block with sham catheter