Knee Arthroscopy for Pain Control

January 7, 2026 updated by: Aaron Casp, University of Alabama at Birmingham

Anterolateral Geniculate Nerve Block and Portal Anesthesia in Knee Arthroscopy for Pain Control: A Randomized Control Trial

This study aims to determine the effectiveness of an anterolateral genicular nerve block and portal anesthesia in controlling pain in the perioperative period after knee arthroscopy. Opioid consumption, the use of non-opioid medications, complication rate, and sleep quality will also be measured.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Detailed Description

Orthopaedic surgeries are some of the most painful operations to recover from, especially when involving cruciate ligaments. Because of this, orthopaedic surgeons have worked to optimize postoperative pain management that provides the best relief. Opioids traditionally were the primary medication for pain control during the perioperative period, however, with the current opioid epidemic and opioids being the leading cause of accidental deaths in the United States, physicians have transitioned to multimodal pain control which has shown to provide better pain control. In cases involving knee arthroscopy, pain management options include variations of nerve blocks, medications, surgical techniques, and postoperative activity.

An anterolateral genicular nerve block has been proposed that focuses on decreasing postoperative pain in the lateral aspect of the knee by targeting the lateral retinacular nerve, the nerve to the vastus lateralis, and the articular branch of the nerve to the vastus intermedius. Adductor canal blocks and intraarticular injections are known methods of providing postoperative pain control, but due to their risks, they may be inappropriate for knee arthroscopy. An anterolateral geniculate nerve block targets sensory, terminal nerve fibers outside the joint capsule, theoretically avoiding the risks of large nerve irritation and chondrotoxicity. Postoperative portal injections are another form of analgesia provided after knee arthroscopy and have been demonstrated to be equally effective in controlling pain as intraarticular injections one hour postoperatively. Otherwise, portal injections in knee arthroscopy have not been extensively studied in the literature.

Patients will be sent home after surgery with a survey to be completed at 2, 4, 6, 12, 24, and 48 hours and 1 week. The survey will inquire about the period from the prior survey to the current survey and will evaluate pain via Visual Analog Score, opioid consumption, non-opioid medication use, sleep, and intervention complications. Patients will be called at 12 and 48 hours and 1 week as reminders to complete the survey.

Study Type

Interventional

Phase

  • Not Applicable

Contacts and Locations

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

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • skeletally mature patients with indications for knee arthroscopy

Exclusion Criteria:

  • include patients with previous knee surgery on the operative side
  • opioid use within six weeks before surgery that is deemed to be chronic or excessive
  • gabapentin use within six weeks before surgery
  • diagnosis of chronic pain, fibromyalgia, or other somatosensory disorder(s)
  • history of radicular pain or neuropathy in the operative limb
  • patients with cancer

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: No Intervention
Patients will receive no intervention
Active Comparator: Nerve Block
Patients in the anterolateral geniculate nerve block group will receive 20 cc of 0.25% bupivacaine with epinephrine distributed evenly between two injection sites by an 18G or 21G long needle. After completion of knee arthroscopy, the first injection is targeted at 2 fingerbreadths superior to the superolateral aspect of the patella. The needle is inserted down to the femur, pulled back slightly, and the surrounding area is infiltrated with 10 cc of anesthetic. The second injection is targeted approximately 2 to 3 fingerbreadths laterally to the first injection and 2 to 3 fingerbreadths proximal to the lateral epicondyle in line with the lateral femur. Once again, the needle is inserted down until bone is encountered and then slightly retracted 1 to 2 mm before infiltration with the remaining 10 cc of anesthetic.
Procedure: Nerve Block
anterolateral geniculate nerve block
Active Comparator: Portal Anesthesia
Patients in the portal anesthesia group will also receive 20 cc of 0.25% bupivacaine with epinephrine distributed evenly between portal sites. After completion of knee arthroscopy, portal tracts are closed and the knee is ensured to be evacuated of residual fluid. An 18G or 21G long needle is then used to infiltrate each portal tract where the anesthetic will be delivered.
Procedure: Portal Anesthesia
portal anesthesia

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative Pain Management
Time Frame: 2, 4, 6, 12, 24, and 48 hours and 1 week post-op
Collected variables will include average and worst pain (0-10 scale, higher values representing increased pain), dose frequency of prescribed opioid analgesics, consumption of prescribed nonopioid analgesics, the longest period of uninterrupted sleep (in hours; only obtained at 12 and 24 hours and 1 week), and the subjective quality of sleep (0-10 scale, higher values representing better sleep), and overall satisfaction with pain control (five-point Likert scale, higher values representing increased satisfaction). A Visual Analog Score will be used in the evaluation of pain.
2, 4, 6, 12, 24, and 48 hours and 1 week post-op

Collaborators and Investigators

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

Sponsor

University of Alabama at Birmingham

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

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 (Estimated)

December 1, 2025

Primary Completion (Estimated)

August 1, 2026

Study Completion (Estimated)

October 1, 2026

Study Registration Dates

First Submitted

November 11, 2024

First Submitted That Met QC Criteria

November 20, 2024

First Posted (Actual)

November 22, 2024

Study Record Updates

Last Update Posted (Actual)

January 9, 2026

Last Update Submitted That Met QC Criteria

January 7, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB-300013299
  • UAB (Other Identifier: UAB)

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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