Incidence of Adductor Canal Catheter Dislodgment

Active, not recruiting

• Conditions: Total Knee Arthroplasty
• Interventions: Procedure: Adductor Canal Catheter

• Registration Number: NCT05961085
• Lead Sponsor: Sunnybrook Health Sciences Centre

Brief 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.

Detailed 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.

Study Timeline

• Status Verified: 2023-07
• Study Start: 2023-07-10
• Study First Submitted: 2023-07-11
• Study First Submitted QC: 2023-07-24
• Study First Posted: 2023-07-27
• Last Update Submitted: 2024-01-11
• Last Update Posted: 2024-01-12
• Primary Completion: 2024-12
• Study Completion: 2025-12

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 100

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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Adductor Canal Catheter	Adductor Canal Catheter	Pre-operative adductor canal catheter placement

Primary Outcome Measures

Name	Time	Method
Adductor Canal Catheter tip in correct position on postoperative day 1	Postoperative day 1 (08:00AM)	Ultrasound confirmation of injectate spread adjacent to the femoral artery on postoperative day 1 (08h00)

Secondary Outcome Measures

Name	Time	Method
Postoperative opioid consumption (08h00)	Postoperative day 1 (08:00AM)	Cumulative opioid consumption after total knee arthroplasty to postoperative day 1 (08h00)
Numeric Rating Scale for Pain (NRS) at rest on postoperative day 1 (08h00)	Postoperative day 1 (08:00AM)	Maximum pain score on 0-10 Likert Scale
Adductor Canal Catheter tip in correct position after insertion	Preoperative	Ultrasound confirmation of injectate spread adjacent to the femoral artery before surgery
Sensory block	Postoperative day 1 (08:00AM)	Loss of sensation in the saphenous nerve distribution on postoperative day 1 (08h00)

Trial Locations

Locations (1)

Sunnybrook Health Sciences Centre; 🇨🇦 Toronto, Ontario, Canada