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Phase 4 N=50 Randomized Double-blind Supportive Care

Evaluation of Utility of Ultrasound Guided iPACK Block for Knee Extension After Total Knee Arthroplasty.

Knee Osteoarthritis · Primary Total Knee Arthroplasty · Physical Therapy · Pain · Knee Extension

Enrolled (actual)
50
Serious AEs
0.0%
Results posted
Dec 2021
Primary outcome: Primary: Number of Participants Able to Hyperextend the Knee After Surgery — 4; 3 Participants

Study Design & Population

Study type
Interventional
Phase
Phase 4
Interventions
Ropivacaine (Drug); Interspace Between the Popliteal Artery and Capsule of the Knee (iPACK) Block (Procedure); Saline (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Duke University
Primary completion
Jan 2021

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Participants Able to Hyperextend the Knee After Surgery
4; 3
SECONDARY
Ambulation as Measured by Distance Walked After Surgery
120.36; 148.8
SECONDARY
Pain as Measure by Numerical Rating Scale (NRS) 11
4.64; 5
SECONDARY
Cumulative Opioid Consumption
47.52; 48.98

Summary

The purpose of this study is to learn if using an Interspace between the Popliteal Artery and Capsule of the Knee (iPACK) injection technique (also called a "nerve block") that numbs the nerves going to the back part of the knee to aid in physical therapy after surgery. The iPACK technique uses a numbing solution (local anesthetics) that is injected behind the knee to reduce pain and to help straighten the knee. This block may affect movement in the leg and make the legs weak, but thing is rare. A few institutions use the iPACK block for patients having total knee replacements, with the hope of providing good pain relief combined with improved mobility after surgery.

Eligibility Criteria

Inclusion Criteria

  • English speaking
  • Between 18 and 75 years old
  • American Society of Anesthesiologists (ASA) 1-3 patients undergoing primary total knee arthroplasty

Exclusion Criteria

  • ASA 4 or 5
  • Revision knee arthroplasty
  • Diagnosis of chronic pain
  • Daily chronic opioid use (over 3 months of continuous opioid use)
  • Inability to communicate pain scores or need for analgesia
  • Acute knee dislocation/fracture
  • Infection at the site of block placement
  • Age under 18 years old or greater than 75 years old
  • Pregnant women
  • Intolerance/allergy to local anesthetics
  • Weight <50 kg
  • Suspected, or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years.
  • Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the opinion of the investigator, may interfere with study assessments or compliance
  • Current or historical evidence of any clinically significant disease or condition that, in the opinion of the investigator, may increase the risk of surgery or complicate the subject's postoperative course.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03353233). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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