Evidence map›Paper›PMID 40186749›Full record

Trial reportArchives of orthopaedic and trauma surgery2025

No superior method for analgesia after total knee arthroplasty: randomised controlled comparison of adductor canal block combined with iPACK block versus posterior capsule block.

Mehmet Fevzi Cakmak, Serkan Bayram, Levent Horoz, Fatma Nur Arslan, Onur Utku Demir, Safa Gürsoy

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mehmet Fevzi CakmakDepartment of Orthopedics and Traumatology, Kirsehir Ahi Evran University, Kirsehir, Turkey.
Serkan BayramDepartment of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. dr.serkanbayram89@gmail.com.ORCID http://orcid.org/0000-0001-9338-8232
Levent HorozDepartment of Orthopedics and Traumatology, Kirsehir Ahi Evran University, Kirsehir, Turkey.
Fatma Nur ArslanDepartment of Anesthesiology, Kirsehir Ahi Evran University, Kirsehir, Turkey.
Onur Utku DemirDepartment of Orthopedics and Traumatology, Kirsehir Ahi Evran University, Kirsehir, Turkey.
Safa GürsoyDepartment of Orthopedics and Traumatology, Acibadem University, Istanbul, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study compare the effectiveness of the space between the popliteal artery and the posterior knee capsule (iPACK) and posterior capsule injection (PCI) in patients with primary end stage knee osteoarthritis treated with total knee arthroplasty (TKA).

methodsThis was a double-blind, prospective, randomised trial. A total of 195 participants were randomly assigned to one of three groups: Group 1 with an adductor canal block (ACB) plus iPACK. Group 2 with ACB + PCI and a final control group with ACB only. All participants underwent primary total knee arthroplasty. Outcome measures comprised pain assessment using the Visual Analog Scale (VAS) and monitoring opioid analgesic consumption. VAS measurements were taken at the 1st, 6th, 12th, 24th, 48th, and 72nd hours, followed by the 10th day and the 12th week.

resultsAge, sex, BMI and side of surgery were analyzed and no significant differences were found. Groups ACB + iPACK and ACB + PCI exhibited significantly lower VAS scores compared to the control group at 3, 6, and 12 h after surgery, with group ACB + iPACK showing the lowest VAS scores among all groups. No significant difference in VAS values between groups was detected after 24 h postoperatively and after that. Significant differences were observed between groups in opioid consumption. The values for the first hour, first day, second day, and total consumption exhibited statistically significant differences between the groups.

conclusionOur study has shown that PCI in combination with ACB is not inferior to the iPACK technique. It is our belief that these combination techniques can be used in accordance with the surgeon's experience and preference. It is important to remember that PCI is quicker and easier to perform without using ultrasonography.

Indexed as

Arthroplasty, Replacement, KneeNerve BlockOsteoarthritis, KneePostoperative PainAgedAnalgesics, OpioidAnesthetics, LocalDouble-Blind MethodFemaleHumansJoint CapsuleMaleMiddle AgedPain MeasurementProspective StudiesAnalgesics, OpioidAnesthetics, LocalAdductor canal blockageiPACK blockageTotal knee arthroplastyVisual analog scale

Identifiers

PMID40186749
PMCPMC11972175

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Registered trials

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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.