Anterior Femoral and Adductor Canal Nerve Blocks in Peds Knees

October 1, 2025 updated by: Hospital for Special Surgery, New York

A Pilot Study Comparing Anterior Femoral Cutaneous Nerve Blocks to Adductor Canal Blocks in Pediatric Ambulatory Knee Surgeries

The goal of this pilot clinical trial is to compare anterior femoral cutaneous nerve block (AFCN) to adductor canal block ACB) for pediatric patients undergoing either anterior cruciate ligament (ACL) or medial patellofemoral ligament (MPFL). The aims of this trial are:

  • To measure postoperative functional outcomes in patients who received AFCNB vs. ACB.
  • To calculate postoperative opioid requirements in pediatric knee surgeries that received AFCNB vs. ACB.
  • To calculate pain intensity levels at rest and with ambulation in patients who received AFCNB vs. ACB.
  • To quantify sensory deficits in patients who received AFCNB vs. ACB.
  • To assess patient-reported outcome measures (e.g., pain expectation scale, pain management satisfaction, PROMIS Pediatric Short Form v1.0 - Physical Activity, PROMIS Scale v1.2 - Global Health) in patients 8-18 years of age who received AFCNB vs. ACB.

Subjects undergoing ACL procedures will be compared between those who received the adductor canal block to those who received the anterior femoral cutaneous nerve block. The researchers will also compare individuals who underwent MPFL procedures and received an anterior femoral cutaneous nerve block with those who received the adductor canal block.

Participants will:

  • Be randomized to receive either the AFCNB or ACB in addition to standard of care analgesia.
  • Maintain a patient diary to document daily pain meds/pain scores
  • Complete follow up surveys/questionnaires via telephone and during their office visits with surgeons.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

There is scant literature on the efficacy of peripheral nerve blocks or the comparative effectiveness of anesthesia and analgesia techniques in pediatric/adolescent patients undergoing orthopedic procedures, particularly ambulatory knee procedures such as anterior cruciate ligament (ACL) reconstruction and medial patellofemoral ligament (MPFL) reconstruction. Given the innervation to the knee and concern with residual functional impairment, the goal of our pilot study is to collect preliminary information comparing the anterior femoral cutaneous nerve block (AFCNB) vs adductor canal block (ACB), in the hopes of using this data to power a larger randomized controlled trial to rigorously study this clinical question.

This pilot clinical trial aims to find out what the differences are between anterior femoral cutaneous nerve block (AFCN) and adductor canal block (ACB) for pediatric patients who are having either anterior cruciate ligament (ACL) or medial patellofemoral ligament (MPFL) surgery. There will be 30 subjects in each group/type of surgery. The aims of this trial are:

  • To measure postoperative functional outcomes in patients who received AFCNB vs. ACB.
  • To calculate postoperative opioid requirements in pediatric knee surgeries that received AFCNB vs. ACB.
  • To calculate pain intensity levels at rest and with ambulation in patients who received AFCNB vs. ACB.
  • To quantify sensory deficits in patients who received AFCNB vs. ACB.

  • To assess patient-reported outcome measures (e.g., pain expectation scale, pain management satisfaction, PROMIS Pediatric Short Form v1.0 - Physical Activity, PROMIS Scale v1.2 - Global Health) in patients 8-18 years of age who received AFCNB vs. ACB.

    30 Subjects undergoing ACL procedures will be compared between those who received the adductor canal block (15) to those who received the anterior femoral cutaneous nerve block (15). The researchers will also compare 30 individuals who underwent MPFL procedures and received an anterior femoral cutaneous nerve block (15) with those who received the adductor canal block (15).

Eligible and enrolled participants will:

  • Be randomized to receive either the AFCNB or ACB in addition to standard of care analgesia.
  • Maintain a patient diary to document daily pain meds/pain scores
  • Complete follow up surveys/questionnaires via telephone and during their office visits with surgeons.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • United States
    • New York
      • New York, New York, United States, 10021
        • Recruiting
        • Hospital for Special Surgery
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • 8-18 years old at the time of surgery
  • Patients 40kg and above
  • ACL reconstruction of MPFL reconstruction surgery with participating surgeons

Exclusion Criteria:

  • revision surgery
  • bilateral surgery
  • general anesthesia
  • contraindications to any part of the study protocol
  • relevant pre-existing neurological deficit
  • chronic pain

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Anterior Cruciate Ligament (ACL) surgeries
Pediatric subjects who underwent a Anterior Cruciate Ligament (ACL) surgery and are randomized to receive either the adductor canal block (ACB) or the anterior femoral cutaneous nerve block (AFCNB).
Drug: Bupivacaine, Dexamethasone in Adductor Canal Block
0.25% 15-20ml bupivacaine (local anesthestic) delivered as part of the adductor canal block with 2 mg preservative-free dexamethasone (corticosteroid) delivered as part of the adductor canal block
Other Names:
  • Adductor Canal Block (ACB)
Drug: Bupivacaine, Dexamethasone in Anterior Femoral Cutaneous Nerve Block
10 ml of 0.25% bupivacaine (local anesthetic) delivered as part of the anterior femoral cutaneous nerve block with 2 mg preservative-free dexamethasone (corticosteroid) delivered as part of the anterior femoral cutaneous nerve block
Other Names:
  • Anterior Femoral Cutaneous Nerve Block (AFCNB)
Experimental: Medial Patellofemoral Ligament (MPFL) surgeries
Pediatric subjects who underwent a Medial Patellofemoral Ligament (MPFL) surgery and are randomized to receive either the adductor canal block (ACB) or the anterior femoral cutaneous nerve block (AFCNB).
Drug: Bupivacaine, Dexamethasone in Adductor Canal Block
0.25% 15-20ml bupivacaine (local anesthestic) delivered as part of the adductor canal block with 2 mg preservative-free dexamethasone (corticosteroid) delivered as part of the adductor canal block
Other Names:
  • Adductor Canal Block (ACB)
Drug: Bupivacaine, Dexamethasone in Anterior Femoral Cutaneous Nerve Block
10 ml of 0.25% bupivacaine (local anesthetic) delivered as part of the anterior femoral cutaneous nerve block with 2 mg preservative-free dexamethasone (corticosteroid) delivered as part of the anterior femoral cutaneous nerve block
Other Names:
  • Anterior Femoral Cutaneous Nerve Block (AFCNB)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative Function (Motor strength in quadriceps)
Time Frame: 3 months
Collected at standard of care postoperative clinical visits with surgeon. Quadriceps strength is measured bilaterally by a handheld dynamometer.
3 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total opioid consumption (MMEs)
Time Frame: at postoperative day 7 & 14
defined as cumulative opioid consumption (in MME) from PACU transfer in time to 7 days postoperatively and from PACU transfer in time to 14 days postoperatively
at postoperative day 7 & 14
postoperative sensation
Time Frame: at 2 weeks, 6 weeks, 3 months, and 6 months
collected at standard of care postoperative clinical visits (2 weeks, 6 weeks, 6 months). Will be measured on a knee dermatomal map (with incisions depicted) and classified as "normal," "decreased," or "paresthesia" when compared to the contralateral knee.
at 2 weeks, 6 weeks, 3 months, and 6 months
postoperative function - motor strength in quadriceps
Time Frame: at 2 weeks, 6 weeks, 6 months
collected at standard of care postoperative clinical visits with surgeon; quadriceps strength: measured bilaterally by handheld dynamometer
at 2 weeks, 6 weeks, 6 months
postoperative function - range of motion (ROM)
Time Frame: at 2 weeks, 6 weeks, 3 months, 6 months
collected at standard of care postoperative clinical visits with surgeon; range of motion (ROM): measured bilaterally by goniometer
at 2 weeks, 6 weeks, 3 months, 6 months
postoperative function - Patient-Reported Outcomes Measurement Information System (PROMIS) physical function.
Time Frame: at 2 weeks, 6 weeks, 3 months, 6 months
collected at standard of care postoperative clinical visits with surgeon; physical function: PROMIS. If the patient is less than 18 years of age, will be assessed using the PROMIS Pediatric Short Form v1.0 - Physical Activity, which contains questions regarding performance of activities such as exercise and play in the past 7 days with 5 answer choices: no days, 1 day, 2-3 days, 4-5 days, and 6-7 days. If the patient is 18 years of age, will be assessed using the PROMIS Scale v1.2 - Global Health, which contains questions regarding physical and mental health rated 1-5, where 1 is worst and 5 is best (physical raw, T, and health scores will be calculated).
at 2 weeks, 6 weeks, 3 months, 6 months
Cumulative opioid consumption (MMEs)
Time Frame: 48 hours after surgery
Opioids administered to or consumed by patient in the first 48 hours after surgery (starting from "PACU in" time to 48 hours after "PACU in" time)
48 hours after surgery
Opioid consumption
Time Frame: at 6 weeks, 3 months, 6 months
defined as any opioid consumption at 6 weeks, 3 months, 6 months postoperatively
at 6 weeks, 3 months, 6 months
Pain Numerical Rating Scale (NRS) at rest
Time Frame: preop (baseline); every 30 minutes beginning from PACU transfer in time to discharge; at 6 hours, 24 hours, 48 hours, 7 days, 14 days, 6 weeks, 3 months, 6 months postoperatively
Defined on a scale of 0-10, where 0 is no pain and 10 is the worst pain imaginable.
preop (baseline); every 30 minutes beginning from PACU transfer in time to discharge; at 6 hours, 24 hours, 48 hours, 7 days, 14 days, 6 weeks, 3 months, 6 months postoperatively
Pain Numerical Rating Scale (NRS) with ambulation
Time Frame: preop (baseline); in PACU; at 6 hours, 24 hours, 48 hours, 7 days, 14 days, 6 weeks, 3 months, 6 months postoperatively
Defined on a scale of 0 to 10, where 0 is no pain and 10 is the worst pain imaginable.
preop (baseline); in PACU; at 6 hours, 24 hours, 48 hours, 7 days, 14 days, 6 weeks, 3 months, 6 months postoperatively
Postoperative pain location(s)
Time Frame: at 2 weeks, 6 weeks, 3 months, 6 months
Collected at standard of care postoperative clinical visits (2 weeks, 6 weeks, 3 months, 6 months). Will be collected on a knee dermatomal map (with incisions depicted) with location(s) of pain marked and average pain scores at each location
at 2 weeks, 6 weeks, 3 months, 6 months
Pain expectation scale
Time Frame: at postoperative days 1, 2, 7, and 14
patient reported on a scale of less, same, or more [or unknown] than expected. With "less" being the lower score and "more" being the higher score.
at postoperative days 1, 2, 7, and 14
Satisfaction with pain management
Time Frame: at postoperative days 1, 2, 7, and 14
measured on a scale from 0 to 10, where 0 is very dissatisfied and 10 is very satisfied with the pain management regimen.
at postoperative days 1, 2, 7, and 14

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hospital for Special Surgery, New York

Investigators

  • Principal Investigator: Kathryn DelPizzo, MD, Hospital for Special Surgery, New York

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 6, 2025

Primary Completion (Estimated)

June 1, 2027

Study Completion (Estimated)

January 1, 2028

Study Registration Dates

First Submitted

August 6, 2024

First Submitted That Met QC Criteria

September 6, 2024

First Posted (Actual)

September 19, 2024

Study Record Updates

Last Update Posted (Estimated)

October 6, 2025

Last Update Submitted That Met QC Criteria

October 1, 2025

Last Verified

October 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024-0582

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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