Infiltration or Nerve Blocks in Addition to Adductor Canal Block
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Analgesia, Analgesia.
- Who it may be relevant to
- Registry conditions: Gonarthrosis, Total Knee Arthroplasty. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- France
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Comparison of the Benefit of Peripheral Nerve Quadri-block Versus Adductor Canal Block + Surgical Infiltration in Total Knee Arthroplasty
Overview
The aim of this study is to evaluate the analgesic efficacy of this quadruple sensory block compared with the currently recommended procedure (adductor canal block + infiltration).
Detailed description
In addition to the adductor canal block, this quadruple block incorporates :
1. the block of the lateral cutaneous nerve of the thigh (or femoral-cutaneous nerve), which is a collateral sensory branch of the posterior part of the lumbar plexus. 2. IPACK (Infiltration between Popliteal Artery and Capsule of Knee), designed as a motor-sparing technique (targeting the sensory articular branches of the sciatic nerve and avoiding the motor branches of the tibial and fibular nerves), is particularly effective on posterior pain. 3. obturator nerve block, a mixed nerve originating from the anterior part of the lumbar plexus. It divides into two branches: anterior, which innervates the adductor longus, adductor brevis and gracilis muscles, and posterior, which innervates the medial part of the knee joint and the posteromedial part of the thigh. It provides sensitivity to the medial aspect of the thigh.
Interventions
- Procedure Analgesia
1- Real Adductor canal block + surgical infiltration and sham of femoro-cutaneous block + obturator block + IPACK block with physiological serum - Procedure Analgesia
2- Real Adductor canal block + femoral-cutaneous block + obturator block + IPACK block and sham of surgical infiltration with physiological serum
Primary outcome measures
- Patient's recovery at H24 as after surgery assessed by the QoR-15 (Quality of Recovery) questionnaire score [Time frame: From enrollement to the last H24 after surgery]
Secondary outcome measures (12)
- Knee functional assessment [Time frame: Hour 0]
- Post operative pain [Time frame: Hour 2]
- Post operative pain [Time frame: Hour 6]
- Post operative pain [Time frame: Hour 12]
- First ambulation [Time frame: Hour 12]
- Post operative pain [Time frame: Hour 24]
- Joint range of both knees [Time frame: Hour 24]
- First ambulation [Time frame: Hour 24]
- Post operative pain [Time frame: Hour 48]
- Quality of recovery [Time frame: Hour 48]
- Opioid drug use [Time frame: Hour 48]
- Non-opioid drug use [Time frame: Hour 48]
Eligibility criteria
Inclusion criteria
- Adult male or female
- Patient with signed consent to participate in the study,
- Patient with uni or bilateral primary gonarthrosis
- Indication for total knee arthroplasty.
Exclusion criteria
- History of knee fracture, arthroplasty or osteotomy
- Known or unknown contraindication to ALR or locoregional anesthesia products
- Neurological disease, stroke sequelae
- Mental deficiency or any other reason that may hinder understanding or strict application of the protocol
- Patient not affiliated to the French social security system
- Patient under court protection, guardianship or curatorship
- Pregnant or potentially pregnant women (women of childbearing age without effective contraception)
- Patient already included in another therapeutic study protocol
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Triple blind
- Primary purpose
- Other
Study locations
France · 2 centers
- Hôpital Privé Claude Galien — Quincy-sous-Sénart
- Clinique des Côtes du Rhône — Roussillon
Publications
- Elmaleh Y, Maupain O, Guessous K, Kattou F, Laurent R, Giral T, Garnier T, Delvaux B. Comparison of a four-nerve block protocol versus adductor canal block plus local infiltration analgesia for primary total knee arthroplasty in two French private hospitals: protocol for the multicentre randomised INCA trial. BMJ Open. 2026 Jul 21;16(7):e119093. doi: 10.1136/bmjopen-2026-119093. PMID 42481203
Identifiers
NCT: NCT06920186 · COS-RGDS-2024-06-006-P-ELMALEH · 2024-A02496-41