Adductor Canal Block vs Intra-articular Catheter in Total Knee Arthroplasty: A Double Blinded Randomized Clinical Trial

Abstract

Aims: Approximately half of patients undergoing Total Knee Arthroplasty (TKA) experience severe perioperative pain. The ideal analgesic regimen for perioperative pain control in patients undergoing TKA is yet to be determined. Methods: A prospective, double-blinded, randomised clinical trial was performed, comparing adductor canal blocks versus intra-articular pain catheters in 100 patients undergoing unilateral total knee replacement by a single surgeon. All other analgesic aspects of the perioperative care were kept standard. Patients underwent an identical surgical approach and all received an Attune TKA (Depuy etc). Post-operative pain levels, Range of Movement (ROM) and opioid equivalent breakthrough analgesia were recorded. All assessors were blinded to group allocation. In addition patients completed WOMAC and Oxford knee scores. Southampton wound score was used to detect adverse outcomes.Results: There were no differences in baseline demographics between the groups preoperative Visual Analogue Pain Score (VAS), Oxford Knee Scores (OKS) or WOMAC scores. Conclusion:A single shot adductor canal block is not inferior to an intra-articular catheter for perioperative pain management in total knee arthroplasty.