Incidence of Adductor Canal Catheter Dislodgment

Total Knee Arthroplasty Clinical Trial

Official title:

Positioning of Continuous Adductor Canal Catheters After Total Knee Arthroplasty

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT05961085
• Other study ID #: 5845
• Status: Active, not recruiting
• Start date: July 10, 2023
• Est. completion date: December 2025

Study information

• Verified date: July 2023
• Source: Sunnybrook Health Sciences Centre
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The goal of this observational study is to determine the incidence of dislodgement for adductor canal catheters after total knee arthroplasty on post-operative day 1. We will also attempt to identify factors associated with secondary catheter failure.

Description:

Total knee arthroplasty (TKA) is a common procedure for indications including osteoarthritis and malignancy involving the knee, with over 55,285 knee replacements performed between 2020-2021 in Canada. Ultrasound guided continuous adductor canal block (cACB) is the standard of care for postoperative analgesia for this procedure. The catheter is not always as effective at providing analgesia as would be expected - which could be due to displacement of the catheter. This displacement is most likely to occur peri-operatively or during physiotherapy post-operatively and as such, post-operative assessments can provide useful insight into causes of secondary failure. This prospective observational study aims to estimate the cACB dislodgment on POD 1 rate at a high volume, tertiary care referral centre, and identify factors associated with dislodgement and clinical sequelae. As this is an observational/QI study of the current standard of care at Sunnybrook Health Sciences Centre, anesthesiologists are free to use the cross sectional versus parallel insertion of the cACB per their discretion.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 100
• Est. completion date: December 2025
• Est. primary completion date: December 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 50 Years and older

Eligibility

Inclusion Criteria:

• Patients scheduled for Total Knee Arthroplasty
• Older than 50 years

Exclusion Criteria:

• Body Mass Index greater than 40
• Chronic opioid consumption (greater than 30mg oral morphine equivalent daily)
• Contraindication to Adductor Canal Catheter

Related Conditions & MeSH terms

• Total Knee Arthroplasty

Intervention

Procedure:
• Adductor Canal Catheter
Ultrasound guided Adductor Canal Catheter for total knee arthroplasty analgesia

Locations

Country	Name	City	State
Canada	Sunnybrook Health Sciences Centre	Toronto	Ontario

Sponsors (1)

Lead Sponsor	Collaborator
Sunnybrook Health Sciences Centre

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Adductor catheter occlusion	Any recording of local anesthetic infusion pump recording an occlusion	Postoperative day 1 (08:00AM)
Other	Patient satisfaction with analgesia on postoperative day 1	Patient satisfaction measured by 0-10 Likert Scale	Postoperative day 1 (08:00AM)
Primary	Adductor Canal Catheter tip in correct position on postoperative day 1	Ultrasound confirmation of injectate spread adjacent to the femoral artery on postoperative day 1 (08h00)	Postoperative day 1 (08:00AM)
Secondary	Adductor Canal Catheter tip in correct position after insertion	Ultrasound confirmation of injectate spread adjacent to the femoral artery before surgery	Preoperative
Secondary	Sensory block	Loss of sensation in the saphenous nerve distribution on postoperative day 1 (08h00)	Postoperative day 1 (08:00AM)
Secondary	Postoperative opioid consumption (08h00)	Cumulative opioid consumption after total knee arthroplasty to postoperative day 1 (08h00)	Postoperative day 1 (08:00AM)
Secondary	Numeric Rating Scale for Pain (NRS) at rest on postoperative day 1 (08h00)	Maximum pain score on 0-10 Likert Scale	Postoperative day 1 (08:00AM)