Clinical trial NCT01345604: Intraoperative Posterior Cruciate Ligament (Transcruciate) Injection After Total Knee Arthroplasty (TKA)
Official title: Reducing Posterior Knee Pain Following Total Knee Arthroplasty Using an Intraoperative Posterior Cruciate Ligament (Transcruciate) Injection
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Arthroplasty, Replacement, Knee
Lead sponsor: University of Saskatchewan
Sponsor class: OTHER
Collaborators: name: Saskatoon Health Region
First posted: 2011-05-02
Enrollment: 50
Sex: ALL
Minimum age (years): 16
Maximum age (years): 100
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: his study is being done because total knee replacements can leave patients with considerable pain after surgery. Therefore, many studies have been done to find the best ways to control knee pain after the surgery. Currently, a popular approach is to use many different techniques to control the pain. This includes injecting freezing (local anesthetic) into the spinal column (spinal anesthetic), injecting freezing close to the nerves of the knee and using various kinds of medications (e.g. narcotics and anti-inflammatory medications). Studies have shown using this a combination of techniques can reduce pain and allow earlier discharge from the hospital. However, one downside to this approach is it does not usually control the pain in the back of the knee. One new technique has been used to try and overcome this. This technique is called a "posterior cruciate ligament block" or "PCL block". It involves injecting a drug into the back of the knee which will block the nerves in this area. Sometimes the investigators refer to this as "freezing".

The purpose of our study is to determine whether this "PCL Block" will improve pain after the total knee replacement surgery. The investigators will also determine whether this technique will improve movement in the knee and lessen narcotic usage after the surgery.


Eligibility criteria: Inclusion Criteria:

* American Society of Anesthesiologists' (ASA) physical status classification (ASA) I and II patients undergoing unilateral total knee arthroplasty at Saskatoon City Hospital
* Patients recruited from the practice of 4 orthopedic surgeons

Exclusion Criteria:

* Inability to obtain informed consent
* Simultaneous bilateral total knee arthroplasty or revision cases
* Preexisting neurological deficits in the distribution of the femoral nerve or known diagnosis of peripheral neuropathy
* Coagulopathies
* Infection either systemically or at the needle insertion sites
* Allergies to local anesthetics or opioids
* Patients with a history of narcotic dependency or chronic pain
* ASA III and IV
* Body Mass Index (BMI) \> 40

Primary outcomes:
measure: Knee flexion
timeFrame: up to one week postoperative
Secondary outcomes:
measure: Postoperative pain score
timeFrame: in PACU , on ward (baseline), and post-op day 1 & 2 at 10am & 6pm
measure: Total narcotic consumption
timeFrame: up to 1 week postoperative
Other outcomes:
Locations:
city: Saskatoon
country: Canada
facility: Saskatoon City Hospital
state: Saskatchewan
Study officials:
References: