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Completed

NCT Number: NCT05601427

Intra-Operative Adductor Canal Blocks

Adductor canal blocks (ACB) have been recommended in total knee arthroplasty (TKA) to provide better control of post-operative pain, facilitate early ambulation, and reduce length of stay in the hospital. ACB is typically done before surgery by an anesthesiologist, which may increase time per case, cost, and requires the specialized skills of an anesthesiologist trained in regional anesthesia. Recent studies have suggested that surgeons can safely and reliably administer the adductor canal blocks (sACB) during surgery. However, there is currently very limited data on the clinical efficacy of such sACBs, and no studies assessing this technique in the context TKA that are discharged the same day. As such, this randomized control trial (RCT) is being done to compare sACBs to conventional anesthesiologist-performed adductor canal blocks (aACB).

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Key information

Conditions

Knee Osteoarthritis Anesthesia Arthritis Joint Diseases Knee Arthritis Knee Pain Chronic Musculoskeletal Diseases Osteoarthritis Osteoarthritis, Knee Rheumatic Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

The Ottawa Hospital

Ottawa, Ontario, Canada

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Male and female patients aged 18 years or older
  • Primary TKA booked as SDD
  • Diagnosis of osteoarthritis

Exclusion criteria

  • Inability or refusal to sign informed consent form
  • Non-English or French speaking, and no licensed translator, family member or substitute decision maker available.
  • Non-osteoarthritis primary diagnosis
  • Allergy to analgesic medications
  • Contraindication to spinal and/or regional anaesthesia
  • Any use of opioid pain medication within four weeks of the index procedure(13)
  • Pain catastrophizing scale score ≥16 (8, 9, 14)
  • History of cirrhosis
  • History renal insufficiency
  • History or sensory and/or motor neuropathy to the ipsilateral limb
  • Simultaneous, bilateral TKA
  • Non-TKA prosthesis
  • Scheduled for non-SDD TKA.
  • Preoperative varus/valgus of >10 degrees.
  • Planned General Anaesthetic
  • Use of Intrathecal Morphine

Treatment and study plan

aACB

Procedure

The patient will undergo a pre-operative single-shot, ultrasound-guided ACB performed by an anaesthesiologist skilled in regional anaesthesia techniques. The ACB will be performed in a dedicated block room, immediately prior to administration of a spinal anaesthetic.

sACB

Procedure

The patient will undergo an intraoperative single-shot ACB performed by the treating surgeon following placement of the TKA components.

Primary outcomes

  1. Patient Report Pain

    Time frame: Up to 24 hours

    Mean Numerical Pain Rating Scale (NPRS) scores on discharge

  2. Pain medication use

    Time frame: When spinal anesthesia resolves until 24 hours after surgery

    morphine equivalents of pain medication

Secondary outcomes

  1. Time to discharge

    Time frame: From PACU to discharge

    Post-operative time in minutes to discharge home

  2. Admission to Hospital

    Time frame: Up to 24 hours post-operative

    Failure to discharge home requiring admission

  3. Readmission Rate

    Time frame: Up to 24 hours post-operative

    Number of patients readmitted to the hospital within 24 hours

  4. Timed Up and Go Test

    Time frame: At discharge

    Time is takes, in seconds, to stand, walk 3m, turn around, walk back 3m, and sit back down

  5. Patient Reported Quality of Recovery

    Time frame: At 24 hours post-operative

    Score on the Quality of Recovery-15 questionnaire

  6. Patient Reported Function

    Time frame: pre-operatively, at 2 weeks post-operative

    Difference in scores on the Oxford knee score (questionnaire), rated from 0-48 with 48 being the best functional outcome and 0 being the worst

  7. Patient Reported Quality of Life

    Time frame: pre-operatively, at 2 weeks post-operative

    Difference in scores on the EQ-5D-5L questionnaire (Euro Quality of Life, 5 Dimension, 5 Level), rated from 11111 - 55555, with 11111 being full health and 55555 being worst health

  8. Patient Reported Global Health

    Time frame: pre-operatively, at 2 weeks post-operative

    Difference in scores on the PROMIS-10 - Global Health (questionnaire), which generates T-scores. Higher T-scores indicate better health.

Sponsors and collaborators

Lead sponsor

Ottawa Hospital Research Institute

Other

Collaborators

  • Canadian Orthopaedic Foundation

Registry information

Official study title

A Randomized Controlled Trial Assessing the Efficacy of Surgeon-performed, Intraoperative Adductor Canal Blocks in Same-Day Discharge Total Knee Arthroplasty

Important dates

Study start
2023
Primary completion
2025
Study completion
2025
First posted
Nov 1, 2022
Registry last updated
May 27, 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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