Femoral Triangle Block Versus Adductor Canal Block in Arthroscopic Anterior Cruciate Ligament Reconstruction

Femoral Triangle Block Versus Adductor Canal Block for Analgesia After Arthroscopic Anterior Cruciate Ligament Reconstruction: A Randomized Trial

The aim of this study is to compare the postoperative analgesic effect of femoral triangle block (FTB) and adductor canal block (ACB)after arthroscopic anterior cruciate ligament (ACL) reconstruction.

Study Overview

• Status: Completed
• Conditions: Anterior Cruciate Ligament Reconstruction; Adductor Canal Block; Femoral Triangle Block
• Intervention / Treatment: Other: Femoral Triangle Block; Other: Adductor Canal Block

Detailed Description

The number of patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction has risen over the past decade. ACL reconstruction is associated with moderate to severe postoperative pain leading to hypertension, tachycardia, increased O2 demand, and myocardial stress.

• Study Type: Interventional
• Enrollment (Actual): 70
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • El-Gharbia
    • Tanta, El-Gharbia, Egypt, 31527
      • Tanta University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age from 21 to 65 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status I and II.
• Undergoing elective arthroscopic Anterior Cruciate Ligament (ACL) reconstruction.

Exclusion Criteria:

• Revisional surgery.
• Body mass index (BMI) >35kg/m2.
• Coagulopathy.
• Infection at site of intervention.
• Hypersensitive to the study drugs.
• Chronic analgesic use.
• Neuromuscular disease.
• Drug abuse.
• Cognitive impairment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Femoral Triangle Block (FTB) Group; Patients will receive femoral triangle block (FTB) at the end of surgery.	Other: Femoral Triangle Block; Patients will receive femoral triangle block (FTB) at the end of surgery. The probe will be positioned at the level where the medial border of the sartorius muscle intersects the medial border of the adductor longus muscle, a block needle advanced in an in-plane technique into femoral triangle. After negative aspiration, 2ml of saline will be injected to confirm the needle tip position close to the femoral artery then injection of 15ml of bupivacaine 0.25% will be performed.
Experimental: Adductor Canal Block (ACB) Group; Patients will receive adductor canal block (ACB) at the end of surgery.	Other: Adductor Canal Block; Patients will receive adductor canal block (ACB) at the end of surgery. The probe will be positioned at the point midway between the anterior superior iliac spine and the upper pole of the patella. The adductor canal will be located as a hyperechoic structure beneath the Sartorius muscle and a block needle advanced in an in-plane technique toward the target nerve after negative aspiration, 2ml of saline will be injected into adductor canal to confirm the block needle tip within it, the block needle will be advanced with the guidance of ultrasound in an in-plane technique and 15ml bupivacaine 0.25% will be injected.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total morphine consumption	Rescue analgesia of 3 mg morphine IV will be given if the Numeric Rating Scale (NRS) > 3 to be repeated after 30 min if pain persists until the NRS < 4. NRS will be assessed at 2, 4, 6, 12, and 24h postoperatively	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time of 1st rescue analgesia	Postoperatively, all patients will receive paracetamol 1gm/6h and diclofenac sodium 75mg I.M/12h as regular analgesia. Rescue analgesia of 3 mg morphine IV will be given if the Numeric Rating Scale (NRS) > 3 to be repeated after 30 min if pain persists until the NRS < 4. NRS will be assessed at 2, 4, 6, 12, and 24h postoperatively.	24 hours postoperatively
Pain score using Numeric Rating Scale (NRS)	Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) (0 represents "no pain" while 10 represents "the worst pain imaginable"). It will be assessed at 2, 4, 6, 12, and 24h postoperatively.	24 hours postoperatively
Quadriceps strength	Quadriceps strength will be assessed at 2, 4, 6, 12, and 24h postoperatively. The criteria for evaluation of quadriceps strength are as follow: I (no contraction), II (have contraction, but cannot move joint), III (can move joint, but cannot resist gravity), IV (can resist gravity, but cannot bear substantial resistance), V (can bear a certain intensity of resistance), and VI (can bear full resistance).	24 hours postoperatively
Patient satisfaction	Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied)	24 hours postoperatively

Collaborators and Investigators

• Sponsor: Tanta University

Study record dates

Study Major Dates

• Study Start (Actual): May 7, 2024
• Primary Completion (Actual): April 27, 2025
• Study Completion (Actual): April 27, 2025

Study Registration Dates

• First Submitted: May 2, 2024
• First Submitted That Met QC Criteria: May 2, 2024
• First Posted (Actual): May 7, 2024

Study Record Updates

• Last Update Posted (Actual): July 31, 2025
• Last Update Submitted That Met QC Criteria: July 30, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 36264MS559/4/24

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No