Mobility After Total Knee Arthroplasty
Conditions
Keywords
Total Knee Arthroplasty, Adductor Canal Blockade, Us-guided nerve blockade
Brief summary
The purpose of the study is to compare the effect of a Adductor Canal Blockade (ACB) vs a Femoral Nerve Blockade (FNB), on muscle strength, mobility and pain in patients with severe pain (VAS pain score \> 60) after Total Knee Arthroplasty (TKA.
Detailed description
The patients will be included after surgery (the first 2 postoperative days). Patients reporting VAS \> 60 during active flexion of the knee can be included. All included patients will receive 2 blockades at the same time - an ACB and a FNB, one blockade with 30ml ropivacaine 0,2% and the other with 30ml saline according to randomization. Prior to, and after, the blockades VAS pain scores will be obtained, muscle strength (quadriceps and adductors) will be measured using a handheld dynanometer and a Timed Up and Go test will be performed. The study is registered at clinicaltrials.gov after inclusion of the first patient. The reason for this is that we recently became aware of that some journals do not accept a EudraCT registration. The study was registered at EudraCT (2012-004554-28)prior to enrollment of patients.
Interventions
DRUGRopivacaine
DRUGPlacebo
Sponsors
University Hospital, Gentofte, Copenhagen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
30 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* TKA within 72 hours and VAS\>60 during 45 degrees active flexion of the knee despite conventional pain medication * informed consent * ASA 1-3 * BMI 18-40
Exclusion criteria
* Unable to communicate in Danish * Allergic reactions toward ropivacaine * Alcohol and or drug abuse * Unable to cooperate * Known sensory disturbances in the lower limbs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change i muscle strength of the quadriceps muscle, after the blockade | 0 and 120 minutes | Maximum Voluntary Isometric Contraction (MVIC) of the quadriceps femoris muscle will be measured before and 2 hours after the blockade. The change will be compared between the groups. At each measuring point three measurements will be made and the average of these used. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| muscle strength, adductor muscles | 0 and 120 minutes | MVIC of the adductors will be measured before and 2 hours after the blockades. The change will be compared between the groups. At each measuring point three measurements will be made and the average of these used. |
| Timed Up and Go (TUG)test | 0 and 120 minutes | The change in time to perform a TUG test before and after the blockades will be compared between the groups. Also the change in highest pain score during the TUG tests will be compared between the groups |
| VAS pain scores at rest | 0 and 120 minutes | VAS pain scores at rest will be obtained before VAS pain scores during passive flexion of the knee. The change between groups will be compared |
| Pain during passive flexion of the knee | 0 and 120 minutes | VAS pain scores during passive 45 degrees flexion of the knee. The change will be compared between the groups. VAS during passive flexion will be obtained prior to the MVIC measurements and the TUG test |
Countries
Denmark
Outcome results
None listed