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Anterior cruciate ligament reconstruction with the use of adductor canal block can achieve similar pain control as femoral nerve block

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Moderate-to-severe postoperative pain remains a challenge for both patients and surgeons after anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to systematically review the current evidence in the literature to compare adductor canal block (ACB) with femoral nerve block (FNB) in the treatment of ACLR.

Methods

A comprehensive search of the published literature in PubMed, Scopus, EMBASE, and Cochrane Library databases was performed. Only English randomized clinical trials (RCTs) were included in this study. The primary outcome was pain score. Secondary outcome measures included opioid consumption, postoperative adverse events, patient satisfaction, and quadriceps strength.

Results

Eight RCTs with a total of 587 patients were included. No statistically

significant difference was observed between the ACB and FNB groups in pain scores at 6 h, 12 h, 24 h, or 48 h; cumulative opioid consumption at 24 h or 48 h; patient satisfaction at 24 or 48 h; and postoperative adverse event. However, ACB showed superior quadriceps strength in the early postoperative period.

Conclusions

Both treatments provided similar overall pain relief after ACLR. The

potential benefits of quadriceps preservation with ACB are worthy of future study.

Therefore, ACB is recommended as an attractive alternative to FNB as the peripheral nerve block of choice for ACLR.

Level of evidence

Meta-analysis of Level 1 was performed in this study.

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Authors and Affiliations

  1. Department of Orthopedics, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, 92 Aiguo Road, Nanchang, 330006, Jiangxi, China

    Huan Min & Gang Chen

  2. Department of Orthopedics, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China

    Yulong Ouyang

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  1. Huan Min
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Correspondence to Gang Chen.

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Min, H., Ouyang, Y. & Chen, G. Anterior cruciate ligament reconstruction with the use of adductor canal block can achieve similar pain control as femoral nerve block. Knee Surg Sports Traumatol Arthrosc 28, 2675–2686 (2020). https://doi.org/10.1007/s00167-020-05933-6

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  • DOI: https://doi.org/10.1007/s00167-020-05933-6

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