Background Minimally invasive knee replacement surgery has grown in early twenty-first century to join international trend of ambulatory joint surgery. Both ultrasound-guided femoral nerve block (FNB) and adductor canal block (ACB) have excellent postoperative analgesia following uni-knee replacement. Minimal motor power affection facilitates early patient ambulation and rehabilitation. Therefore, the objective of this study is to evaluate and compare the functional recovery and analgesic efficacy of both techniques in uni-knee arthroplasty. Methods After University Review Board approval, informed written consent to participate in the study was obtained. Patients scheduled for unicompartmental knee arthroplasty (UKA) with combined spinal-epidural anesthesia were eligible for enrollment in this double blind, randomized trial. Patients received either FNB or ACB with a 20 cc of 0.5% of bupivacaine with 5 μg/ml epinephrine. Quadriceps muscle strength was measured as primary outcome using Medical Research Council scale (MRC). Postoperative pain with visual analog scale (VAS) and total morphine consumption was considered as secondary outcome, all recorded for 48 h post-anesthesia administration. Results Eighty patients were analyzed; quadriceps strength was significantly lower in the FNB group compared with ACB group especially at 12 postoperative hour (2 versus 4), respectively, p value < 0.05. There was no difference between the groups regarding postoperative. VAS at rest except at 24 h was significantly lower in FNB group with p value 0.003. The gate disturbance and the number of falls were significantly lower in the ACB group than the FNB group (2 compared to 9), respectively. There was no difference between groups regarding postoperative nausea, vomiting, and itching. Conclusion ACB preserved quadriceps muscle strength more than FNB, with reduced number of falls and without significant difference in pain relief. Therefore, ACB considered an alternative to FNB when given as supplemental postoperative pain control after unicompartmental knee arthroplasty. Trial registration This clinical trial was registered in the Pan African Clinical Trial Registry (PACTR) http://www.pactr.org/ as a prospective trial with the identification number PACTR201907788767332.

Background:Bipolar hemiarthroplasty (BA) has long been the preferred treatment and is performed in most patients with femoral neck fracture (FNF). The dual mobility cup total hip arthroplasty (DMTHA) has emerged as a relevant alternative to BA. Since then there is an on-going debate on the best implant to use. Age, comorbidities, patient independence, and potential surgical complications must be considered when choosing implants. The risk of dislocation is a crucial factor because of its important consequences. The authors evaluated the functional and mechanical outcomes of BA versus DMTHA in FNF in active elderly patients. Methods:This study was a randomized comparative interventional singleblinded study that was performed at Ain Shams University Hospitals. A total of 33 patients underwent DMTHA or BA after displaced FNF. Primary outcomes were functional outcome and postoperative dislocation rate. Secondary outcomes were operative time and amount of blood loss. Results:There were no significant differences between the demographic data and preoperative parameters between the two groups. There was a significant difference in the postoperative Harris Hip Score (HHS) between the two groups (P = 0.01). VAS of groin pain was significantly different between the two groups (P < 0.001). There was no significant difference between the two groups regarding the dislocation rate. Conclusions:The authors concluded that DMTHA offered a better functional outcome than BA with no significant complications or mortality, and there was no significant difference between DMTHA and BA in the rate of dislocation.