Adductor Canal Catheter vs Local Infiltration of Analgesia for Total Knee Arthroplasty
Adductor Canal Catheter vs Local Infiltration of Analgesia for Total Knee Arthroplasty
The study is a prospective randomized controlled trial comparing local infiltration of
 analgesia in the knee joint and adductor canal catheters for postoperative analgesia
 following a primary Total Knee Arthroplasty (TKA).
The study is a prospective, randomized controlled clinical trial comparing two methods of
 postoperative analgesia following primary TKA. Eligible primary TKA patients must be ASA I -
 III and require less than 20 mg oxycodone daily (or its equivalent). Exclusion criteria are:
 allergy to anesthetics, contraindication to regional anesthesia, sensory/ motor disorder
 involving operative limb, non-english speaking, ASA IV or greater, psychiatric or cognitive
 disorders, incarceration, renal insufficiency with Cr > 2.0 and hepatic failure. When
 patients agree to participate in the study the following data will be collected by the
 research staff: ASA physical status, age, height, weight, gender, quantitative opiate use,
 numeric pain score with visual descriptors, painDETECT score, WOMAC score and baseline Pain
 Management Questionnaire. When designated through randomization, local infiltration of
 analgesia will be placed intraoperatively by the surgeons, per usual protocol and patients in
 the LIA group will receive sham adductor canal catheter. All ACC's for both study groups will
 be placed postoperatively in the PACU. Those collecting data will be blinded from identifying
 patients in the control group, as both groups will have ACC placed with same technique.
 Potential risks for each procedure, which will be explained to the patient, include:
 bleeding, local infection, local anesthetic toxicity in the form of seizure and cardiac
 arrest and neuropathy. The preceding are commonly listed though infrequent complications of
 both procedures. Continuous ultrasound will guide the placement of the ACC. All adductor
 canal catheters will remain in for 72 hours. Pt from LIA group will be discharged home with
 sham catheter with a saline infusion at 10 ml/hr via an ambulatory pump. Patients in ACC
 group will be discharged with continuous adductor canal catheter delivering ropivacaine 0.2%
 at 10 ml/hr via an ambulatory pump. Patients will be called daily for pain diary results. As
 well as at 6-8 weeks postoperatively to collect painDetect and WOMAC survey.
Inclusion Criteria:

 -  Age 40-85

 -  American Society of Anesthesiologists (ASA) Physical Status (PS) 1-3. • Undergoing
 Unilateral, Primary, Total Knee Arthroplasty

 -  English as native language

 Exclusion Criteria:

 -  Patient refusal

 -  History of opioid dependence

 -  Contraindication to peripheral nerve block • Pre-existing significant neuropathy