Incidence of Adductor Canal Catheter Dislodgment

Positioning of Continuous Adductor Canal Catheters After Total Knee Arthroplasty

The goal of this observational study is to determine the incidence of dislodgement for adductor canal catheters after total knee arthroplasty on post-operative day 1. We will also attempt to identify factors associated with secondary catheter failure.

Study Overview

• Status: Active, not recruiting
• Conditions: Total Knee Arthroplasty
• Intervention / Treatment: Procedure: Adductor Canal Catheter

Detailed Description

Total knee arthroplasty (TKA) is a common procedure for indications including osteoarthritis and malignancy involving the knee, with over 55,285 knee replacements performed between 2020-2021 in Canada. Ultrasound guided continuous adductor canal block (cACB) is the standard of care for postoperative analgesia for this procedure. The catheter is not always as effective at providing analgesia as would be expected - which could be due to displacement of the catheter. This displacement is most likely to occur peri-operatively or during physiotherapy post-operatively and as such, post-operative assessments can provide useful insight into causes of secondary failure. This prospective observational study aims to estimate the cACB dislodgment on POD 1 rate at a high volume, tertiary care referral centre, and identify factors associated with dislodgement and clinical sequelae. As this is an observational/QI study of the current standard of care at Sunnybrook Health Sciences Centre, anesthesiologists are free to use the cross sectional versus parallel insertion of the cACB per their discretion.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M4N 3M5
      • Sunnybrook Health Sciences Centre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All patients referred to Sunnybrook Health Sciences Centre scheduled for primary total knee arthroplasty

Description

Inclusion Criteria:

• Patients scheduled for Total Knee Arthroplasty
• Older than 50 years

Exclusion Criteria:

• Body Mass Index greater than 40
• Chronic opioid consumption (greater than 30mg oral morphine equivalent daily)
• Contraindication to Adductor Canal Catheter

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Adductor Canal Catheter; Pre-operative adductor canal catheter placement	Procedure: Adductor Canal Catheter; Ultrasound guided Adductor Canal Catheter for total knee arthroplasty analgesia

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adductor Canal Catheter tip in correct position on postoperative day 1	Ultrasound confirmation of injectate spread adjacent to the femoral artery on postoperative day 1 (08h00)	Postoperative day 1 (08:00AM)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adductor Canal Catheter tip in correct position after insertion	Ultrasound confirmation of injectate spread adjacent to the femoral artery before surgery	Preoperative
Sensory block	Loss of sensation in the saphenous nerve distribution on postoperative day 1 (08h00)	Postoperative day 1 (08:00AM)
Postoperative opioid consumption (08h00)	Cumulative opioid consumption after total knee arthroplasty to postoperative day 1 (08h00)	Postoperative day 1 (08:00AM)
Numeric Rating Scale for Pain (NRS) at rest on postoperative day 1 (08h00)	Maximum pain score on 0-10 Likert Scale	Postoperative day 1 (08:00AM)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adductor catheter occlusion	Any recording of local anesthetic infusion pump recording an occlusion	Postoperative day 1 (08:00AM)
Patient satisfaction with analgesia on postoperative day 1	Patient satisfaction measured by 0-10 Likert Scale	Postoperative day 1 (08:00AM)

Collaborators and Investigators

• Sponsor: Sunnybrook Health Sciences Centre

Study record dates

Study Major Dates

• Study Start (Actual): July 10, 2023
• Primary Completion (Estimated): December 1, 2025
• Study Completion (Estimated): December 1, 2025

Study Registration Dates

• First Submitted: July 11, 2023
• First Submitted That Met QC Criteria: July 24, 2023
• First Posted (Actual): July 27, 2023

Study Record Updates

• Last Update Posted (Estimated): September 12, 2025
• Last Update Submitted That Met QC Criteria: September 5, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 5845

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified data will be available upon request
• IPD Sharing Time Frame: Upon publication, no limit on time
• IPD Sharing Access Criteria: Contact study investigators
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No