Summary: The purpose of this study was to investigate the novel placement of a catheter placed between the muscles that make up the adductor canal accessed during a standard para-patella surgical approach in TKA.

Introduction

Total knee arthroplasty (TKA) is considered to be one of the more painful medical procedures routinely performed today. Pain management in TKA patients is challenged by a postoperative requirement for early ambulation along with a concurrent goal to reduce opioid consumption while reducing the hospital stay. Peripheral nerve blocks (PNB) address these concerns to some degree, with femoral nerve block, and adductor canal block being the most commonly used regional nerve blocks for surgeries performed around the knee joint.

Purpose

The purpose of this study was to investigate the novel placement of a catheter placed between the muscles that make up the adductor canal accessed during a standard para-patella surgical approach in TKA. This catheter placement was compared to standard anesthesia placements performed under ultrasound guidance.

Study Design: Cadaveric Study

Methods

The study was conducted in 12 fresh-frozen human cadaveric lower limbs

Results

Using colored indicator dyes to clearly locate the site of surrogate peripheral nerve blocks, this cadaveric study demonstrated that a standard surgical approach to the knee provides an excellent exposure to the medial intermuscular septum adjacent to the adductor canal. Through a standard anterior surgical approach to the knee a novel intraoperative catheter placement technique can be performed to provide a peripheral nerve block for patients undergoing TKA comparable or potentially superior to standard ultrasound guided anesthesia block techniques.

Conclusion

The present cadaveric study has demonstrated that a standard approach for a TKA provides an excellent exposure to the medial intermuscular septum adjacent to the adductor canal, allowing for placement of a PNB. This novel intraoperative catheter placement technique administered by the surgeon is a safe and efficient method to provide for extended relief of post-TKA pain.

Keywords: Adductor Canal Blocks, pain management, Total Knee Arthroplasty

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Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees ePoster Presentation Shinichiro Nakamura, MD, PhD, JAPAN Shota Takemoto, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Hiromu Ito, MD, PhD, JAPAN Mutsumi Watanabe, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Shuichi Matsuda, MD, PhD, JAPAN
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block with Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation David Freccero, MD, UNITED STATES Aneesh V Samineni, BA, UNITED STATES Seroos Salavati, MD, UNITED STATES
The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Matthew Carter, NEW ZEALAND Gavin William Clark, MBBS, FRACS, AUSTRALIA Christina Esposito, PhD, AUSTRALIA Matthew Walker, MBChB, FRACS, NEW ZEALAND
Association Between The Femoral And Tibial Component Positions and Intraoperative Knee Kinematics In Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Combined Fixed-Bearing Unicompartmental Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction ePoster Presentation Claudio Legnani, MD, ITALY Enrico Borgo, MD, ITALY Vittorio Macchi, MD, ITALY Alberto Ventura, MD, ITALY
Same Complication Rate After Day-Case Procedure Or Fast-Track Procedure After Total Hip And Knee Arthroplasty. A Prospective, Propensity Score-Matched Case-Control Study ePoster Presentation Jean-Yves Jenny, Prof., FRANCE Vincent Gisonni, MD, FRANCE
Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Matias Novillo, MD, ARGENTINA Tomas Nicolino, MD, ARGENTINA Matias Costa-Paz, MD, PhD, ARGENTINA Lisandro Carbó, MD, ARGENTINA Julian Costantini, MD, ARGENTINA
Subtalar Joint Compensation using Full-length Standing Lower Extremity Anteroposterior Radiograph after Total Knee Arthroplasty for Varus Osteoarthritis in Nara Medical University Hospital with 2-year Follow-up ePoster Presentation Jerre Co De Guzman, MD, PHILIPPINES Munehiro Ogawa, MD, PhD, JAPAN Yusuke Ozaki, MD, JAPAN Yasuhito Tanaka, Prof., JAPAN Yuki Nishimura, MD, JAPAN Maria Elizabeth Mercado, MD, MAS, PHILIPPINES

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Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study

Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study

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Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study

Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study

Introduction

Purpose

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content