NCT07524387

Femoral Triangle Block vs Adductor Canal Block on Early Quadriceps Function After Total Knee Arthroplasty

Postoperative Effects of Femoral Triangle Block Versus Adductor Canal Block on Early Quadriceps Function After Total Knee Arthroplasty Under a Multimodal Analgesia Protocol: A Randomized Double-Blind Controlled Trial

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 136 (estimated)
• Sponsor: Social Medical Corporation Daiyukai · Academic / Other
• Sex: All
• Age: 20 Years
• Healthy volunteers: Not accepted

Summary

The goal of this clinical trial is to compare the effects of femoral triangle block (FTB) and adductor canal block (ACB) on early quadriceps function after total knee arthroplasty (TKA). The main question it aims to answer is whether FTB causes more early quadriceps functional impairment than ACB under a standardized multimodal analgesia protocol. Researchers will compare FTB and ACB using a composite binary functional outcome measured 6 hours after block completion. Quadriceps functional impairment is defined as the inability to perform a structured straight leg raise or quadriceps muscle strength \<50% of the preoperative baseline. Participants will be randomly assigned to receive ultrasound-guided FTB or ACB. All participants will also receive a popliteal plexus block and standardized multimodal analgesia.

Detailed description

This is a single-center, randomized, parallel-group clinical trial designed to compare the postoperative effects of femoral triangle block (FTB) and adductor canal block (ACB) on early quadriceps function after primary unilateral total knee arthroplasty (TKA). A total of 136 adult participants are planned for enrollment at Daiyukai General Hospital. Participants will be randomly assigned to receive ultrasound-guided FTB or ultrasound-guided ACB as part of a standardized multimodal analgesia protocol. In all participants, a popliteal plexus block will also be performed to standardize posterior knee analgesia. The primary outcome is quadriceps functional impairment at 6 hours after block completion, assessed using a composite binary functional outcome defined as the inability to perform a structured straight leg raise or normalized isometric quadriceps muscle strength \<50% of the preoperative baseline. Secondary outcomes include quadriceps functional impairment at 24 hours after block completion using the same composite definition, postoperative pain intensity, rescue analgesic consumption, early mobilization and rehabilitation-related measures, active knee range of motion, time to achieve active knee flexion of at least 120 degrees, and ultrasound-assessed local anesthetic spread. The study aims to determine whether FTB results in greater early motor impairment than ACB under a standardized multimodal analgesia protocol while maintaining clinically appropriate postoperative analgesia.

Conditions

• Total Knee Arthroplasty
• Total Knee Arthroplasty Recovery
• Total Knee Arthroplasty Postoperative Pain

Interventions

Type	Name	Description
PROCEDURE	Femoral Triangle Block (FTB) Group	Ultrasound-guided femoral triangle block performed as part of a standardized multimodal analgesia protocol for total knee arthroplasty. A total of 10 mL of 0.25% levobupivacaine is injected in the femoral triangle to achieve sensory blockade of the saphenous nerve, the nerve to vastus medialis, and surrounding structures. The injection is performed at the distal femoral triangle under ultrasound guidance, targeting the perineural space adjacent to the relevant nerve branches. In all participants, a popliteal plexus block using 15 mL of 0.25% levobupivacaine is additionally performed to standardize posterior knee analgesia.
PROCEDURE	Adductor Canal Block (ACB) Group	Ultrasound-guided adductor canal block performed as part of a standardized multimodal analgesia protocol for total knee arthroplasty. A total of 10 mL of 0.25% levobupivacaine is administered in a divided manner within the proximal adductor canal, targeting both the saphenous nerve within the canal and the nerve to vastus medialis running adjacent to the canal. The injection is performed under ultrasound guidance to achieve selective sensory blockade while minimizing motor involvement. In all participants, a popliteal plexus block using 15 mL of 0.25% levobupivacaine is additionally performed to standardize posterior knee analgesia.

Timeline

• Start date: 2026-04-13
• Primary completion: 2029-03-15
• Completion: 2029-03-31
• First posted: 2026-04-13
• Last updated: 2026-04-16

Locations

1 site across 1 country: Japan