Early Ambulation After Adductor Canal Block for Total Knee Arthroplasty

Study Overview
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Brief Summary
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The purpose of this study is to assess early ambulation following total knee replacement in patients receiving continuous adductor canal block with posterior capsular injection compared to continuous femoral nerve block with tibial nerve block.

Official Title
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Assessment of Early Ambulation in Patients Receiving Continuous Adductor Canal Block With Ultrasound Guided Posterior Capsular Knee Injection vs. Femoral Nerve Block With Tibial Nerve Block Following Total Knee Replacement

Conditions
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Pain, Osteoarthritis

Intervention / Treatment
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* Procedure: Canal Block and Capsular Injection
* Procedure: Femoral Nerve Block with Tibial Nerve Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: knee arthroplasty ages 18-80 Exclusion Criteria: history of neurological disease diabetes pregnancy neuropathy chronic narcotic use allergy to local anesthetic solution or NSAIDS inability to give consent or cooperate with the study protocol

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Canal Block and Capsular Injection<br>Adductor canal block with a continuous catheter and ultrasound guided posterior capsular injection with local anesthetic solution. | Procedure: Canal Block and Capsular Injection<br>* Continuous Adductor canal block with 15ml of ropivacaine 0.2% with epinephrine 1:400,000 followed by an infusion of ropivacaine 0.2% at 6ml per hour for 2 days post operatively. This is combined with ultrasound guided posterior capsular knee injection with 30ml ropivacaine 0.2% with epinephrine 1:400,000.<br>|
| Active Comparator: Femoral with Tibial Nerve Block<br>Continuous femoral nerve block with catheter and selective tibial nerve block in the popliteal fossa. | Procedure: Femoral Nerve Block with Tibial Nerve Block<br>* Continuous femoral nerve block with 15ml of ropivacaine 0.2% followed by an infusion of ropivacaine 0.2% at 6ml per hour for 2 days after surgery combined with tibial nerve block in the popliteal fossa with ropivacaine 0.5% up to 15ml.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ability to ambulate post operatively. | Ability to ambulate and perform tasks of the rehabilitation program and reach rehabilitation milestones after total knee arthroplasty. | Up to 3 days (72 hours) post surgery. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain scores at rest and with knee flexion. | Measures of pain score using numeric pain rating scale (0=no pain, 10=worst pain) completed by patient in recovery room and every 6 hours for a 72 hour period after discharge from recovery room. | Up to 3 days ( 72 hours) after surgery | 
| Pain Medication Consumption | Amount of opioid consumption post surgery for 72 hours. | Up to 3 days (72 hours) post surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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early ambulation, knee arthroplasty