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NCT Number: NCT07568106

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

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.

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Key information

Conditions

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

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Cukurova University

Adana, Saricam, 01330, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

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

Exclusion criteria

  • 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°

Treatment and study plan

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.

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.

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.

Primary outcomes

  1. Posterior Knee Pain Intensity

    Time frame: 6 hours postoperatively

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

Secondary outcomes

  1. Postoperative Pain Intensity

    Time frame: 30 minutes, 1, 6, 12, 24, and 48 hours postoperatively

    Pain intensity at rest and during movement assessed using the Numeric Rating Scale (NRS, 0-10).

  2. Total Opioid Consumption

    Time frame: 0-48 hours postoperatively

    Total opioid consumption measured from patient-controlled analgesia (PCA) device and additional opioid requirements, expressed in milligrams of morphine equivalent.

  3. Rescue Analgesic Use

    Time frame: 0-48 hours postoperatively

    Requirement for additional analgesic medications (e.g., meperidine, paracetamol, ibuprofen) recorded as yes/no and total doses administered.

  4. Functional Recovery

    Time frame: 24 hours, 48 hours, and 6 weeks postoperatively

    Functional recovery assessed by range of motion (ROM), quadriceps muscle strength, time to first ambulation, ability to walk 10 meters without assistance, and performance on the 5-times sit-to-stand test.

  5. Quadriceps Muscle Strength

    Time frame: Preoperatively, 24 hours, 48 hours, and 6 weeks postoperatively

    Quadriceps isometric muscle strength measured using a handheld dynamometer and expressed in Nm/kg.

  6. Time to First Ambulation

    Time frame: Within 48 hours postoperatively

    Time from the end of surgery to first successful ambulation, measured in hours.

  7. Patient Satisfaction

    Time frame: 48 hours postoperatively

    Patient satisfaction with postoperative pain management assessed using a 4-point scale (excellent, good, moderate, poor).

Study contacts

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

Demet Lafli Tunay, M.D.

CONTACT

[email protected]

+905358685831

Sponsors and collaborators

Lead sponsor

Cukurova University

Other

Registry information

Official study title

Effect of Adding a Biceps Femoris Short Head Block to an Adductor Canal Block on Postoperative Pain and Functional Outcomes After Total Knee Arthroplasty: A Randomized Controlled Trial

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
May 5, 2026
Registry last updated
May 5, 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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