Pain Management Techniques for ACL Surgery

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Davis

Disqualifiers: Prior knee surgery, Pregnancy, Arthritis, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

60 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial compares pain control methods for ACL surgery patients, using either a nerve block or oral medications. It aims to see if both methods provide similar pain relief and recovery outcomes. The study will also assess the cost-effectiveness and patient flow logistics of each method.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Adductor Canal Nerve Block for pain management in ACL surgery?

Research shows that the Adductor Canal Block (ACB), which numbs specific nerves in the leg, effectively reduces pain and the need for opioids after major knee surgeries, including ACL reconstruction. ^{1 2 3 4 5}

Is the adductor canal nerve block safe for pain management in ACL surgery?

The adductor canal nerve block (a type of local anesthetic injection) is generally considered safe for pain management in knee surgeries, including ACL reconstruction, as it primarily affects sensory nerves and reduces pain without significant side effects. ^{2 3 4 6 7}

How is the adductor canal nerve block treatment different from other pain management techniques for ACL surgery?

The adductor canal nerve block is unique because it primarily targets sensory nerves, reducing pain without significantly affecting muscle strength, unlike other nerve blocks that may impair movement. This makes it particularly beneficial for maintaining mobility after ACL surgery. ^{1 2 4 5 8}

Research Team

Cassandra Lee, MD

Principal Investigator

UC-Davis Health

Eligibility Criteria

This trial is for adults aged 18-45 who have confirmed ACL tears and are recommended to undergo reconstructive surgery. It's not suitable for those unable to consent, pregnant women, individuals with inflammatory arthritis, non-English speakers, anyone with prior knee surgeries, or prisoners.

Inclusion Criteria

I am between 18 and 45 years old.

My ACL tear is confirmed by tests and I need surgery.

Exclusion Criteria

I do not speak English.

Prisoners

I have inflammatory arthritis.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-operative

Participants complete the Brief Resiliency Scale questionnaire and receive pre-operative pain medication prescriptions

1 day

1 visit (in-person)

Surgery and Immediate Post-op

Participants undergo ACL reconstruction surgery and complete a Visual Analog Scale for pain assessment in the recovery room

1 day

1 visit (in-person)

Post-operative Treatment

Participants follow a prescribed pain medication regimen and maintain a pain diary for 6 weeks

6 weeks

1 visit (in-person) at 6 weeks

Follow-up

Participants complete the Knee Injury and Osteoarthritis Outcome Score at 3 months and the Marx Activity Rating Scale at 6 months to assess knee function

6 months

2 visits (in-person) at 3 and 6 months

Treatment Details

Interventions

• Adductor Canal Nerve Block
• Ropivacaine injection

Trial Overview The study compares standard pain management techniques during ACL reconstruction surgery. Specifically, it looks at the effectiveness of an adductor canal nerve block using Ropivacaine injection versus no nerve block in controlling pain and improving functional outcomes post-surgery.

Participant Groups

Group I: Adductor Canal Nerve Block Experimental Treatment 2 Interventions

Participant will receive an adductor canal nerve block via 15 mL 0.5% ropivacaine injection prior to OR for ACL reconstruction. Participant will receive pre-op oral medications.

Group II: No Nerve Block Active Control 1 Intervention

Participant will receive pre-op oral medications but no nerve block prior to OR for ACL reconstruction.

Who Is Running the Clinical Trial?

University of California, Davis

Lead Sponsor

Trials

958

Recruited

4,816,000+

Findings from Research

The adductor canal block (ACB) is a promising alternative to the femoral nerve block for managing pain after knee surgeries, particularly knee arthroplasty.

This review discusses the anatomy and ultrasound-guided techniques for ACB, highlighting its potential benefits in pain control and patient recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adductor canal block for knee surgical procedures: review article. Vora, MU., Nicholas, TA., Kassel, CA., et al.[2017]

In a study of 120 patients undergoing total knee arthroplasty, the combination of adductor canal block (ACB) and interspace between popliteal artery and capsule of posterior knee block (IPACK) provided significantly better pain relief compared to ACB alone, as measured by VAS scores.

Patients receiving the ACB+IPACK technique also demonstrated improved range of motion and ambulation distance post-surgery, indicating that this method enhances recovery without compromising motor function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. Sankineani, SR., Reddy, ARC., Eachempati, KK., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Efficacy of Adductor Canal Block Combined With Additional Analgesic Methods for Postoperative Analgesia in Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Study. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Analgesic efficacy of ultrasound-guided adductor canal blockade after arthroscopic anterior cruciate ligament reconstruction: a randomised controlled trial. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Comparison of adductor canal block and femoral nerve block for pain management in anterior cruciate ligament reconstruction: A meta-analysis of randomized controlled trials. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Adductor canal block for knee surgical procedures: review article. [2017]

5. France pubmed.ncbi.nlm.nih.gov

Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. [2022]

6. India pubmed.ncbi.nlm.nih.gov

Femoral nerve block versus adductor canal block for postoperative pain control after anterior cruciate ligament reconstruction: A randomized controlled double blind study. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Adductor Canal Block Versus Femoral Nerve Block for Analgesia After Total Knee Arthroplasty: A Systematic Review and Meta-analysis. [2022]

8. China pubmed.ncbi.nlm.nih.gov

[Research progress on analgesic effect of adductor canal block after knee arthroplasty]. [2023]