2019, Vol. 2, Issue 1, Part A

Background and Objective: Effective postoperative pain control is critical for early mobilization and rehabilitation following total knee arthroplasty (TKA). The femoral nerve block (FNB) has been traditionally used for analgesia, but it may impair quadriceps strength, delaying recovery. The adductor canal block (ACB), a more distal block, offers a potentially motor-sparing alternative. This randomized controlled trial was conducted to compare the analgesic efficacy and functional outcomes of ACB versus FNB in patients undergoing unilateral TKA.

Materials and Methods: A total of 40 patients scheduled for primary unilateral TKA under spinal anesthesia were randomly assigned into two groups (n = 20 each): Group A received an ultrasound-guided adductor canal block, and Group F received a femoral nerve block, both using 20 mL of 0.5% ropivacaine postoperatively. This study was conducted at the Department of Orthopaedics, Surabhi Institute of Medical Sciences, Siddipet-Husnabad, Mundrai, Telangana, India from February 2018 to January 2019. Pain scores using the visual analogue scale (VAS), quadriceps muscle strength, time to ambulation, opioid consumption, and patient satisfaction were assessed at 6, 12, 24, and 48 hours postoperatively. Data were analyzed using appropriate statistical tests, with p < 0.05 considered significant.

Results: Both groups demonstrated effective analgesia with no significant difference in VAS scores at 6 and 12 hours postoperatively (p > 0.05). However, at 24 and 48 hours, Group A (ACB) showed comparable analgesia with significantly better preservation of quadriceps strength (p = 0.01), earlier ambulation (p = 0.02), and reduced risk of falls. Opioid consumption over 48 hours was lower in the ACB group, although not statistically significant. Patient satisfaction scores were higher in the ACB group.