Comparison of immediate post-operative pain and functional outcomes of surgeon-administered adductor canal block through subvastus versus medial parapatellar approach in total knee arthroplasty: A retrospective comparative study.
- 1Department of Trauma and Orthopaedics Saraogi Healthcare and H.N. Reliance Hospital, Mumbai, Maharashtra, India.
- 2Department of Trauma and Orthopaedics, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom.
- 3Department of Trauma and Orthopaedics Saraogi Healthcare, Maharashtra, Mumbai, India.
Abstract
Post-operative pain significantly impedes early rehabilitation after total knee arthroplasty (TKA). The adductor canal block (ACB) provides effective analgesia with minimal quadriceps impairment. This study compares immediate post-operative pain and functional outcomes of surgeon-administered ACB through subvastus (SV) versus medial parapatellar (MP) approaches. In this retrospective comparative study conducted between January 2024 and March 2025, medical records of 60 patients who underwent unilateral primary TKA were reviewed. Patients were grouped based on the surgical approach used for intraoperative surgeon-administered ACB (30 SV, 30 MP). A modified anatomical technique was used in all cases. A standardized multimodal non-opioid post-operative analgesic protocol was used in both groups. Outcomes assessed at 12 h post-operatively included Visual Analog Scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), timed up and go (TUG) test, and range of motion (ROM). Statistical analyses were performed using GraphPad Prism version 8.4.2. Both groups demonstrated significant post-operative improvement in pain and function. The SV group achieved superior pain control (post-operative VAS 3.52 ± 0.69 vs. 4.38 ± 0.82; P = 0.0001), better functional outcomes (WOMAC 60.1 vs. 72.17; P < 0.0001), and faster TUG times (P = 0.0104). ROM improvements were significant in both groups, with no statistically significant intergroup difference. In this retrospective comparative study, the SV approach with surgeon-administered ACB was associated with better immediate post-operative analgesia and functional outcomes than the MP approach. The study cannot determine whether these differences were attributable to the surgical approach, ACB delivery, or both. Larger prospective, randomized studies with longer follow-up are warranted.
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BibTeX
@article{saraogi2026comparison,
title = {{Comparison of immediate post-operative pain and functional outcomes of surgeon-administered adductor canal block through subvastus versus medial parapatellar approach in total knee arthroplasty: A retrospective comparative study.}},
author = {Akash Saraogi and Vishnu Jayaprakasan and Hasan Jhanjharya},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8520},
url = {https://europepmc.org/article/MED/42997093},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Comparison of immediate post-operative pain and functional outcomes of surgeon-administered adductor canal block through subvastus versus medial parapatellar approach in total knee arthroplasty: A retrospective comparative study.
AU - Akash Saraogi
AU - Vishnu Jayaprakasan
AU - Hasan Jhanjharya
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8520
UR - https://europepmc.org/article/MED/42997093
AB - Post-operative pain significantly impedes early rehabilitation after total knee arthroplasty (TKA). The adductor canal block (ACB) provides effective analgesia with minimal quadriceps impairment. This study compares immediate post-operative pain and functional outcomes of surgeon-administered ACB through subvastus (SV) versus medial parapatellar (MP) approaches. In this retrospective comparative study conducted between January 2024 and March 2025, medical records of 60 patients who underwent unilateral primary TKA were reviewed. Patients were grouped based on the surgical approach used for intraoperative surgeon-administered ACB (30 SV, 30 MP). A modified anatomical technique was used in all cases. A standardized multimodal non-opioid post-operative analgesic protocol was used in both groups. Outcomes assessed at 12 h post-operatively included Visual Analog Scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), timed up and go (TUG) test, and range of motion (ROM). Statistical analyses were performed using GraphPad Prism version 8.4.2. Both groups demonstrated significant post-operative improvement in pain and function. The SV group achieved superior pain control (post-operative VAS 3.52 ± 0.69 vs. 4.38 ± 0.82; P = 0.0001), better functional outcomes (WOMAC 60.1 vs. 72.17; P < 0.0001), and faster TUG times (P = 0.0104). ROM improvements were significant in both groups, with no statistically significant intergroup difference. In this retrospective comparative study, the SV approach with surgeon-administered ACB was associated with better immediate post-operative analgesia and functional outcomes than the MP approach. The study cannot determine whether these differences were attributable to the surgical approach, ACB delivery, or both. Larger prospective, randomized studies with longer follow-up are warranted.
SN - 2250-0685
SN - 2321-3817
ER -