Adductor Canal Block Methods in Bilateral Total Knee Arthroplasty

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.

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Key information

Conditions

Knee Osteoarthritis Adductor Canal Block Arthritis Joint Diseases Musculoskeletal Diseases Neurologic Manifestations Osteoarthritis Osteoarthritis, Knee Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Peripheral Nerve Block Postoperative Complications Postoperative Pain Rheumatic Diseases Signs and Symptoms Total Knee Arthroplasty

Age range

60 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

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

Exclusion criteria

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

Treatment and study plan

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.

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.

Primary outcomes

Pain (Numeric Rating Scale)

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

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.

Study contacts

Contact information is provided by the study sponsor or research team.

Kwan-Kyu Park, Professor

CONTACT

[email protected]

+82-2-2228-2183

Sponsors and collaborators

Lead sponsor

Yonsei University

Other

Registry information

Official study title

Comparison of Surgeon-Performed Intraoperative Adductor Canal Block and Ultrasound-Guided Anesthesiologist-Performed Block in Bilateral Total Knee Arthroplasty

Important dates

Study start: 2026
Primary completion: 2029
Study completion: 2029
First posted: Apr 1, 2026
Registry last updated: Apr 1, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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