ArticleClinical orthopaedics and related research2014
Continuous adductor canal blocks are superior to continuous femoral nerve blocks in promoting early ambulation after TKA.
Article in Clinical orthopaedics and related research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 48 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Continuous Adductor Canal Block With Epidural Analgesia for Total Knee Arthroplasty: A Prospective, Randomized, Double-blinded, Placebo-Controlled Trial
Does Single Injection Adductor Canal Block Improve Postoperative Analgesia in Patients Receiving Periarticular Local Anesthesia Injections for Total Knee Arthroplasty?
Does Magnesium Sulfate as a Supplement in Adductor Canal Blocks Improve Pain Control After Total Knee Arthroplasty?
Randomized Controlled Trial Evaluating Postoperative Analgesia and Muscle Strength Between Single Versus Continuous Adductor Canal Block for Ambulatory ACL Reconstruction.
Who cites it
48 citing papers in PubMed, 7 syntheses or guidelines pooled it, 139 citations in OpenAlex.
- Pooled it
- Pooled it
- Adductor canal block versus femoral nerve block for total knee arthroplasty: a meta-analysis of randomized controlled trials.Scientific reports · 2017Pooled it
- Meta-analysis of epidural analgesia versus peripheral nerve blockade after total knee joint replacement.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2017Pooled it
- Analgesic Efficacy of Adductor Canal Block in Total Knee Arthroplasty: A Meta-analysis and Systematic Review.Orthopaedic surgery · 2016Pooled it
- Adductor canal block provides better performance after total knee arthroplasty compared with femoral nerve block: a systematic review and meta-analysis.International orthopaedics · 2016Pooled it
- Pooled it
- No superior method for analgesia after total knee arthroplasty: randomised controlled comparison of adductor canal block combined with iPACK block versus posterior capsule block.Archives of orthopaedic and trauma surgery · 2025Trial
- Continuous adductor canal block added to local infiltration analgesia (LIA) after total knee arthroplasty has no additional benefits on pain and ambulation on postoperative day 1 and 2 compared with LIA alone.Acta orthopaedica · 2017Trial
- Effects of multi-site infiltration analgesia on pain management and early rehabilitation compared with femoral nerve or adductor canal block for patients undergoing total knee arthroplasty: a prospective randomized controlled trial.International orthopaedics · 2017Trial
- Comparison of catheter tip migration using flexible and stimulating catheters inserted into the adductor canal in a cadaver model.Journal of anesthesia · 2015Trial
- Pain trajectory after total knee arthroplasty (TKA) with prolonged use of outpatient adductor canal catheters.Journal of anesthesia and translational medicine · 2025Article
- Management of Postoperative Pain Following Primary Total Knee Arthroplasty: A Level I Evidence-Based Bayesian Network Meta-Analysis.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Validation of a Novel Landmark-guided Intra-articular Postero-medial Surgeon-administered Injection Technique.Arthroplasty today · 2025Article
- Article
- A direct saphenous nerve block in TKA: A surgeon friendly technique! Cadaveric study.Journal of clinical orthopaedics and trauma · 2024Article
- Implementation of the Fast-track Protocol for Total Hip Arthroplasty in a Public Hospital in the State of São Paulo - Brazil.Revista brasileira de ortopedia · 2024Article
- Triple injection peri-sartorius (TIPS) block for postoperative analgesia after total knee arthroplasty: Randomised controlled study.Indian journal of anaesthesia · 2024Article
- [Research progress on analgesic effect of adductor canal block after knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2023Article
- Motor-Sparing Effect of Adductor Canal Block for Knee Analgesia: An Updated Review and a Subgroup Analysis of Randomized Controlled Trials Based on a Corrected Classification System.Healthcare (Basel, Switzerland) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFemoral continuous peripheral nerve blocks (CPNBs) provide effective analgesia after TKA but have been associated with quadriceps weakness and delayed ambulation. A promising alternative is adductor canal CPNB that delivers a primarily sensory blockade; however, the differential effects of these two techniques on functional outcomes after TKA are not well established. QUESTIONS/PURPOSES: We determined whether, after TKA, patients with adductor canal CPNB versus patients with femoral CPNB demonstrated (1) greater total ambulation distance on Postoperative Day (POD) 1 and 2 and (2) decreased daily opioid consumption, pain scores, and hospital length of stay.
methodsBetween October 2011 and October 2012, 180 patients underwent primary TKA at our practice site, of whom 93% (n = 168) had CPNBs. In this sequential series, the first 102 patients had femoral CPNBs, and the next 66 had adductor canal CPNBs. The change resulted from a modification to our clinical pathway, which involved only a change to the block. An evaluator not involved in the patients' care reviewed their medical records to record the parameters noted above.
resultsAmbulation distances were higher in the adductor canal group than in the femoral group on POD 1 (median [10(th)-90(th) percentiles]: 37 m [0-90 m] versus 6 m [0-51 m]; p < 0.001) and POD 2 (60 m [0-120 m] versus 21 m [0-78 m]; p = 0.003). Adjusted linear regression confirmed the association between adductor canal catheter use and ambulation distance on POD 1 (B = 23; 95% CI = 14-33; p < 0.001) and POD 2 (B = 19; 95% CI = 5-33; p = 0.008). Pain scores, daily opioid consumption, and hospital length of stay were similar between groups.
conclusionsAdductor canal CPNB may promote greater early postoperative ambulation compared to femoral CPNB after TKA without a reduction in analgesia. Future randomized studies are needed to validate our major findings. LEVEL OF EVIDENCE: Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.