Post Operative Pain Management for ACL Reconstruction

Rothman Institute Orthopaedics154 enrolled

Overview

Health care providers are seeking methods to limit post-operative pain and opioid prescriptions to reduce the burden of the national opioid use epidemic. Adductor canal block (ACB) is a peripheral nerve block that has been shown to reduce pain and opioid usage with minimal effect on quadriceps function in patients undergoing arthroscopic knee surgery. Infiltration between Popliteal Artery and Capsule of the Knee (iPACK) block has also shown promise in reducing pain and opioid usage, specifically reducing posterior knee pain, which ACB is not able to achieve. To our knowledge, there is currently no study in the orthopedic literature comparing post-operative pain and opioid consumption in ACL reconstruction (ACLR) patients who received isolated ACB versus ACB with IPACK. The primary aim of this study is to investigate the role of IPACK in combination with ACB in reducing peri-operative (14-days) pain levels in ACLR patients. The secondary aim is to determine the effectiveness of IPACK in reducing post-operative opioid use. The tertiary aim is to determine any effect of IPACK on post-operative functional outcomes.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

154

Conditions

Pain, Postoperative

Interventions

Bupivacaine HCl 0.5% Injectable SolutionDRUG

During adductor canal block participants will receive 20cc of Bupivacaine HCl 0.5%

DexamethasoneDRUG

During adductor canal block participants will receive 2mg Dexamethasone

Infiltration between Popliteal Artery and Capsule of the knee (iPACK)PROCEDURE

Prior to closing the surgical wound participants will receive a local injections of 20cc 0.5% bupivacaine mixed with 2mg dexamethasone

Percocet 5Mg-325Mg TabletDRUG

Participant will receive 20 Percocet 5/325mg tablets post surgery for pain control

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * All patients undergoing primary ACLR for ACL tear, including patients with concomitant meniscectomy or meniscal repair. Exclusion Criteria: * Revision ACLR, worker's compensation, pregnancy, age\<18 years

Locations (1)

Rothman Orthopaedic Institute

Philadelphia, Pennsylvania, United States

Outcomes

Primary Outcomes

Post operative pain management

This will be measured by the participants completing a pain and medication Use questionnaire

Time frame: 14 days

Post operative pain management 2

Participants will also complete the International Knee Documentation Committee (IKDC) questionnaires

Time frame: 6 months

Data from ClinicalTrials.gov

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