A Randomized Controlled Trial Comparing Adductor Canal Catheter (ACC) and Intra-articular Catheter (IAC) following Primary Total Knee Arthroplasty

• Published in: The Journal of arthroplasty
• Main Authors: Beausang, David H., MD, Pozek, John-Paul J., MD, Chen, Antonia F., MD, MBA, Hozack, William J., MD, Kaufmann, Marc W., DO, Torjman, Marc C., PhD, Baratta, Jaime L., MD
• Format: Journal Article
• Language: English
• Published: 2016
• Subjects: Orthopedics; multimodal analgesia; adductor canal catheter; intraarticular catheter; primary knee arthroplasty
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2016.01.064

Abstract Background Multimodal analgesia, including peripheral nerve blocks, is recommended for postoperative pain relief after total knee arthroplasty (TKA). To date, no randomized controlled trial has compared the efficacy of adductor canal catheters (ACC) and intra-articular catheters (IAC) in patients undergoing TKA. Methods A prospective, randomized control trial was performed in 96 primary, unilateral TKA patients comparing ACC to IAC between 4/2014-8/2015. Primary outcome measured was numeric pain scores before and after the first PT session on postoperative day 1 (POD 1). Secondary outcomes were oxycodone consumption at 24 and 48 hours, total opioid consumption in morphine equivalents at 24 and 48 hours, active and passive range of motion (ROM) during physical therapy, patient satisfaction and length of stay. Results Results demonstrated that the ACC provided significantly better pain control on POD 1 (p=0.02) compared to the IAC. ACC trended toward significantly reduced oxycodone consumption at 24 hours postoperatively compared to IAC (25.64 vs. 34.67mg, p=0.057). However, total opioid consumption was equivalent between the groups at 24 hrs (32.24 vs 38.55 p =0.185) or 48 hours (45.2 Vs 52.0, p=0.330). Conclusion ACC should be considered as part of a multimodal pain regimen following primary, unilateral TKA and provides a better option for pain control after discharge.