IPICK Blocking for TKA With Moderate Flexion Contracture

Study Overview
=================
Brief Summary
-----------------
Clinical effect of intermittent multiple IPICK blocking on TKA for knee osteoarthritis with flexion contracture between 5 ° and 10 °

Detailed Description
-----------------
From October 2020 to January 2021, 40 knee osteoarthritis patients with flexion contracture between 5 ° and 10 ° total knee arthroplasty are enrolled in this study. 20 patients are treated with Adductor Canal Block + Infiltration between the Popliteal Artery and Capsule of the Knee, and 20 patients are treated with Adductor Canal Block alone.

Official Title
-----------------
IPICK Blocking for Extension Recovery in TKA With Preoperative Moderate Flexion Contracture

Conditions
-----------------
Knee Osteoarthritis, Flexion Contracture of Knees, Anesthesia, Local

Intervention / Treatment
-----------------
* Procedure: CACB+IPACK
* Procedure: CACB


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: The diagnosis was knee osteoarthritis The flexion contracture was between 5 and 10 degrees ASA grade I-III Exclusion Criteria: Lower extremity neuropathy. Contraindications of nerve anesthesia or regional anesthesia. unable to cooperate, allergic to the drugs used in this study. Non steroidal anti-inflammatory drugs are not tolerated. chronic opioid consumption (daily or almost daily use)

Ages Eligible for Study
-----------------
Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: study group<br>The first 20 patients received Continue Adductor Canal Block + Infiltration between the Popliteal Artery and Capsule of the Knee | Procedure: CACB+IPACK<br>* continue adductor canal block plus Infiltration between the Popliteal Artery and Capsule of the Knee<br>|
| Sham Comparator: control group<br>The second 20 patients received Continue Adductor Canal Block alone | Procedure: CACB<br>* continue adductor canal block<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| evaluation of pain | Visual Analog Score for pain at rest, straightening, flexion at 45 ° and walking, the minimum and maximum values are 0 to 10, higher scores mean a worse outcome. | 6 hours after surgery | 
| evaluation of pain | Visual Analog Score for pain at rest, straightening, flexion at 45 ° and walking, the minimum and maximum values are 0 to 10, higher scores mean a worse outcome. | postoperative day 1 | 
| evaluation of pain | Visual Analog Score for pain at rest, straightening, flexion at 45 ° and walking, the minimum and maximum values are 0 to 10, higher scores mean a worse outcome. | postoperative day 2 | 
| evaluation of pain | Visual Analog Score for pain at rest, straightening, flexion at 45 ° and walking, the minimum and maximum values are 0 to 10, higher scores mean a worse outcome. | postoperative day 3 | 
| extension angle | degree of the extension of knee | before surgery | 
| extension angle | degree of the extension of knee | 0 hour after surgery | 
| extension angle | degree of the extension of knee | 6 hour after surgery | 
| extension angle | degree of the extension of knee | postoperative day 1 | 
| extension angle | degree of the extension of knee | postoperative day 2 | 
| extension angle | degree of the extension of knee | postoperative day 3 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| range of motion | degree of range of motion from extension to flexion of knee | 6 hour after surgery | 
| range of motion | degree of range of motion from extension to flexion of knee | postoperative day 1 | 
| range of motion | degree of range of motion from extension to flexion of knee | postoperative day 2 | 
| range of motion | degree of range of motion from extension to flexion of knee | postoperative day 3 | 
| opioid consumption | total opioid consumption measured by milliliter. | through hospitalization, an average of 7 days | 
| nerve block related symptoms | the incidence of numbness of the nerve related skin | through hospitalization, an average of 7 days | 
| postoperative acute pain | number of cases whose Visual Analog Score for pain was more than 5 | through hospitalization, an average of 7 days | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
IPACK, knee osteoarthritis, Flexion Contracture of Knees