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NCT Number: NCT07683078

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

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.

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Key information

Conditions

Anterior Cruciate Ligament Injury Anterior Cruciate Ligament Injuries Knee Injuries Leg Injuries Neurologic Manifestations Pain Pain, Postoperative Pathologic Processes Pathological Conditions, Signs and Symptoms Postoperative Complications Signs and Symptoms Wounds and Injuries

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

SBU Bagcilar Education and Training Hospital

Istanbul, ABD Dışında, 34400, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • 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.

Exclusion criteria

  • 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.

Treatment and study plan

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.

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.

Primary outcomes

  1. Postoperative Pain Intensity

    Time frame: 24 hours after surgery

    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).

Secondary outcomes

  1. Postoperative Opioid Consumption

    Time frame: 24 hours after surgery

    Total opioid consumption during the first 24 postoperative hours will be calculated as intravenous morphine equivalent dose (mg).

  2. Time to First Mobilization

    Time frame: 24 hours after surgery

    Time from completion of surgery to the patient's first successful ambulation, recorded in hours.

  3. Length of Hospital Stay

    Time frame: 24 hours after surgery

    Length of postoperative hospital stay measured in hours from the end of surgery until hospital discharge.

Sponsors and collaborators

Lead sponsor

Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization

Other

Registry information

Official study title

Effect of Adding Vastus Medialis Nerve Block to Adductor Canal Block on Postoperative Analgesia Following Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Trial

Acronym: VAMA

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jul 6, 2026
Registry last updated
Jul 14, 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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