Adductor Canal Block Combined With Local Infiltration Analgesia vs Local Infiltration Analgesia Alone for Postoperative Pain in Total Knee Arthroplasty (ADB_01)

April 1, 2026 updated by: Cagla Beyza Colakoglu, Ankara University

Comparison of the Effect of Adductor Canal Block Combined With Local Infiltration Analgesia Versus Local Infiltration Analgesia Alone on Postoperative Pain Scores in Total Knee Arthroplasty

Total knee arthroplasty (TKA) is commonly associated with significant postoperative pain, which may impair early mobilization and functional recovery. Multimodal analgesia techniques are widely used to improve postoperative pain control while minimizing opioid consumption. Local infiltration analgesia (LIA) is a commonly used method; however, its effectiveness may be limited when used alone. The adductor canal block (ACB) provides effective analgesia while preserving quadriceps muscle strength.

This prospective randomized controlled study aims to compare the effectiveness of adductor canal block combined with local infiltration analgesia versus local infiltration analgesia alone on postoperative pain scores in patients undergoing total knee arthroplasty. The primary outcome is postoperative pain assessed using the NRS at multiple time points within the first 48 hours. Secondary outcomes include opioid consumption, functional recovery parameters and hemodynamic parameters.

The results of this study are expected to contribute to optimizing postoperative analgesia strategies in total knee arthroplasty.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Total knee arthroplasty (TKA) is frequently associated with moderate to severe postoperative pain, which can negatively affect early mobilization, rehabilitation, and patient satisfaction. Effective pain management strategies are essential for enhanced recovery protocols. Multimodal analgesia has become the standard approach, combining different techniques to improve analgesic efficacy while reducing opioid-related side effects.

Local infiltration analgesia (LIA) is widely used as part of multimodal analgesia; however, it may not always provide sufficient analgesia when used alone. The adductor canal block (ACB) has gained popularity due to its ability to provide sensory blockade of the saphenous nerve while preserving quadriceps muscle strength, thus facilitating early mobilization.

This prospective randomized controlled trial was conducted to evaluate the effect of combining ACB with LIA compared to LIA alone in patients undergoing total knee arthroplasty. Patients were randomly assigned into two groups: one group received ACB combined with LIA, while the control group received LIA alone.

Postoperative pain was assessed using the Visual Analog Scale (VAS) at 2, 6, 12, 24 and 48 hours postoperatively. Secondary outcomes included total opioid consumption and functional recovery parameters. Demographic data, operative variables, and perioperative characteristics were also recorded and analyzed.

The findings of this study aim to provide evidence regarding the efficacy of combining regional anesthesia techniques with local infiltration analgesia in improving postoperative pain control following total knee arthroplasty.

Study Type

Interventional

Enrollment (Actual)

61

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.

Study Locations

  • Turkey (Türkiye)
    • Ankara
      • Ankara, Ankara, Turkey (Türkiye), 06100
        • Ankara University Faculty of Medicine, Ibni Sina Hospital

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:

  • Patients aged 18 years and older
  • Patients scheduled for elective total knee arthroplasty
  • American Society of Anesthesiologists (ASA) physical status I-III
  • Patients who provided written informed consent

Exclusion Criteria:

  • Known allergy to local anesthetics
  • Coagulation disorders or anticoagulant therapy contraindicating regional anesthesia
  • Infection at the injection site
  • Severe hepatic or renal dysfunction
  • Neurological disorders affecting lower extremities
  • Cognitive impairment preventing pain assessment
  • Refusal to participate
  • Body mass index (BMI) greater than 30 kg/m²

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: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: ACB+LIA
Patients in this group received an adductor canal block combined with local infiltration analgesia for postoperative pain management following total knee arthroplasty.
Procedure: Adductor Canal block
Ultrasound-guided adductor canal block was performed using local anesthetic to provide postoperative analgesia.
Procedure: Local Infiltration Analgesia
Local infiltration analgesia was administered intraoperatively using local anesthetic agents around the surgical site.
Active Comparator: LIA
Patients in this group received local infiltration analgesia alone for postoperative pain management following total knee arthroplasty.
Procedure: Local Infiltration Analgesia
Local infiltration analgesia was administered intraoperatively using local anesthetic agents around the surgical site.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain at rest (Numerating Rating Scale, NRS)
Time Frame: 2,6,12,24,48
Postoperative pain was assessed using the NRS at rest at predefined time points. Postoperative pain was assessed using the Numeric Rating Scale (NRS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Pain scores were recorded at rest at predefined time points.
2,6,12,24,48

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Opioid Consumption
Time Frame: 0-48 hours postoperatively
Total opioid consumption within the first 48 hours postoperatively.
0-48 hours postoperatively
Knee flexion range of motion (degrees) measured with a goniometer
Time Frame: 24 and 48 hours postoperatively
Functional recovery will be assessed by measuring knee flexion range of motion (degrees) using a standard goniometer at predefined postoperative time points.
24 and 48 hours postoperatively
Heart rate (beats per minute)
Time Frame: Baseline (preoperative) and every 15 minutes from induction of anesthesia to extubation
Heart rate (beats per minute) will be recorded at baseline and at 15-minute intervals from induction of anesthesia to extubation.
Baseline (preoperative) and every 15 minutes from induction of anesthesia to extubation
Mean arterial pressure (mmHg)
Time Frame: Baseline (before induction of anesthesia) and every 15 minutes from induction of anesthesia to extubation
Mean arterial pressure (mmHg) will be recorded at baseline (preoperative) and at 15-minute intervals during the intraoperative period.
Baseline (before induction of anesthesia) and every 15 minutes from induction of anesthesia to extubation

Collaborators and Investigators

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

Sponsor

Ankara University

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)

May 31, 2025

Primary Completion (Actual)

November 15, 2025

Study Completion (Actual)

November 15, 2025

Study Registration Dates

First Submitted

March 24, 2026

First Submitted That Met QC Criteria

April 1, 2026

First Posted (Actual)

April 8, 2026

Study Record Updates

Last Update Posted (Actual)

April 8, 2026

Last Update Submitted That Met QC Criteria

April 1, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 08-349-25

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

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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