title: Is continuous adductor canal block better than continuous femoral nerve block after total knee arthroplasty? Effect on ambulation ability, early functional recovery and pain control: a randomized controlled trial.
abstract: Total knee arthroplasty is associated with intense, early post-operative pain. Femoral nerve block is known to provide optimal pain relief but reduces the strength of the quadriceps muscle and associated with the risk of falling. Adductor canal block is almost pure sensory blockade with minimal effect on quadriceps muscle strength. We prospectively randomized 100 patients in two groups' continuous adductor and femoral block group. Ambulation ability (Timed up go, 10-m walk, 30 s chair test), time to active SLR, quadsticks, staircase competency, ambulation distance was significantly better (P value < 0.001) in adductor canal group whereas pain scores, opioid consumption showed no significant difference. Adductor canal block provided better ambulation and early functional recovery but without superior analgesia than femoral nerve block post TKA.
  
  
  METHODS
  Level III, therapeutic study.
authors.affiliation: Bombay Hospital and Research Centre, Marine Lines, Mumbai, Maharashtra, India.
authors.forename: Nilen A
authors.initials: NA
authors.lastname: Shah
authors.affiliation: Bombay Hospital and Research Centre, Marine Lines, Mumbai, Maharashtra, India; Joint Reconstruction Center, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, South Korea.
authors.forename: Nimesh P
authors.initials: NP
authors.lastname: Jain
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005267:Femoral Nerve / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000187:drug effects; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010525:Peripheral Nerves / Q000187:drug effects; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000294:innervation; D020127:Recovery of Function; D016896:Treatment Outcome; D016138:Walking
chemical_list: D000701:Analgesics, Opioid
keywords: adductor canal block; ambulation ability; analgesia; femoral nerve block; total knee arthroplasty