Enhanced Recovery After Major Surgery and Chronic Pain for Total Knee Arthroplasty

Description

The goal of this interventional clinical trial is to assess opioid consumption 24-48 hrs post anesthesia block among patients undergoing total knee arthroplasty. The main question it aims to answer is: 1. Is there a difference in opioid consumption 24-48 hours post block administration among patients that receive an adductor canal catheter (ACC) versus adductor canal block (ACB)? Participants will be: * Randomized to receive an adductor canal catheter (ACC) or a sham adductor canal catheter. * Asked to use the Diagnotes application to communicate with the pain doctor while the catheter is in place. * Follow up for up to 6 months post-operation. Researchers will compare the interventional group (ACC) to the control group (sham ACC + ACB) to see if there is difference in opioid consumption and chronic pain at 6 months post-operation.

Conditions

Chronic Pain, Opioid Use, Adductor Canal Block, Total Knee Arthroplasty

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Study Overview

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Study Details

Study overview

The goal of this interventional clinical trial is to assess opioid consumption 24-48 hrs post anesthesia block among patients undergoing total knee arthroplasty. The main question it aims to answer is: 1. Is there a difference in opioid consumption 24-48 hours post block administration among patients that receive an adductor canal catheter (ACC) versus adductor canal block (ACB)? Participants will be: * Randomized to receive an adductor canal catheter (ACC) or a sham adductor canal catheter. * Asked to use the Diagnotes application to communicate with the pain doctor while the catheter is in place. * Follow up for up to 6 months post-operation. Researchers will compare the interventional group (ACC) to the control group (sham ACC + ACB) to see if there is difference in opioid consumption and chronic pain at 6 months post-operation.

Expanding the Peri-operative Surgical Home Model: ERAS TKR With a Transitional Pain Service (TeleTPS) - Continuous Adductor Canal Catheter Versus Adductor Canal Block for Total Knee Arthroplasty, a Randomized Double-blinded Controlled Trial.

Enhanced Recovery After Major Surgery and Chronic Pain for Total Knee Arthroplasty

Condition
Chronic Pain
Intervention / Treatment

-

Contacts and Locations

New York

Hospital for Special Surgery, New York, New York, United States, 10021

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Patients with osteoarthritis scheduled for a primary total knee arthroplasty with a participating surgeon
  • * Age 18 to 75 years
  • * Planned use of regional anesthesia
  • * Ability to follow study protocol
  • * English speaking (secondary outcomes include questionnaires validated in English only)
  • * Patients of participating surgeons: Drs. Mayman, Jerabek, Westrich, Su, Della Valle, Alexiades
  • * Lives within one hour of the hospital
  • * Has a smartphone
  • * Hepatic or renal insufficiency
  • * Younger than 18 years old and older than 65
  • * Patients undergoing general anesthesia
  • * Allergy or intolerance to one of the study medications
  • * BMI \> 40
  • * Diabetes
  • * ASA of III,IV
  • * Chronic gabapentin/pregabalin use (regular use for longer than 3 months)
  • * PCS \> 30
  • * Chronic opioid use (taking opioids for longer than 3 months, or daily oral morphine equivalent of \>5mg/day for one month)
  • * Patients with severe valgus deformity or flexion contracture
  • * Patients unable to follow home catheter instructions and unwilling to go home with an infusing catheter
  • * Patients who have no home caregivers in the event if a catheter is to be sent home with the patient
  • * Patients with planned stay at rehab facility

Ages Eligible for Study

18 Years to 75 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Hospital for Special Surgery, New York,

Stavros Memtsoudis, MD/PhD, PRINCIPAL_INVESTIGATOR, Hospital for Special Surgery, New York

Justas Lauzadis, PhD, STUDY_DIRECTOR, Hospital for Special Surgery, New York

Study Record Dates

2025-01-01