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
Social Medical Corporation Daiyukai
136 participants
Apr 13, 2026
INTERVENTIONAL
Conditions
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.
Eligibility
Inclusion Criteria6
- Adult patients (≥ 20 years of age) are scheduled to undergo primary unilateral TKA.
- American Society of Anesthesiologists (ASA) physical status I-III.
- Ability to ambulate independently prior to surgery.
- Ability to understand the study procedures and provide written informed consent.
- Planned perioperative anesthesia management including regional anesthesia as part of standard clinical care.
- Ability to extend the knee below 30 degrees preoperatively (no knee extension contracture)
Exclusion Criteria6
- Known allergy or contraindication to local anesthetic agents used in this study.
- Pre-existing neurological or neuromuscular disorders affect lower limb strength or motor control.
- Severe cognitive impairment or psychiatric conditions interfere with study participation or assessment.
- History of revision knee arthroplasty on the operative side.
- Severe preoperative quadriceps weakness that precludes reliable baseline strength assessment.
- Any condition deemed by the investigator to make participation inappropriate.
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Interventions
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.
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.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07524387