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Genicular vs IPACK Block for Analgesia in Knee Arthroplasty

NCT07171931 · Status: NOT_YET_RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 72

Last updated 2025-09-15

No results posted yet for this study

Summary

Total knee arthroplasty (TKA) is one of the most frequently performed orthopedic procedures, and with the aging population, the global number of TKA cases is expected to increase sixfold within the next decade. Postoperative pain following TKA is often severe and difficult to manage, which may increase the risk of developing chronic pain. Effective pain control is therefore a major concern, and multimodal analgesia is recommended to enhance analgesia, reduce opioid consumption, and minimize opioid-related side effects.

Peripheral nerve blocks (PNBs) are an integral part of multimodal regimens. Among them, the adductor canal block (ACB), which provides analgesia to the anteromedial aspect of the knee while preserving motor function, is widely used. The optimal analgesic strategy for TKA should not only ensure adequate pain relief but also maintain quadriceps strength to allow early mobilization. Motor-sparing blocks combined with multimodal analgesia have become increasingly popular because they facilitate early rehabilitation, decrease opioid requirements, and improve recovery outcomes.

The knee joint has a complex innervation, receiving contributions from the femoral, sciatic, and obturator nerves. For this reason, combining different PNBs may provide superior analgesia compared to a single block (2). The genicular nerves, consisting of branches from the femoral, common peroneal, saphenous, tibial, and obturator nerves, innervate the knee capsule. Genicular nerve block specifically targets these branches and has been used to manage postoperative pain in TKA patients.

Another motor-sparing option is the interspace between the popliteal artery and posterior capsule of the knee (IPACK) block, which provides analgesia to the posterior aspect of the knee. Using ultrasound guidance, local anesthetic is deposited between the posterior capsule and the popliteal artery. This approach spares the main trunks of the tibial and common peroneal nerves while effectively blocking the terminal branches innervating the posterior capsule, including the genicular nerves and the popliteal plexus.

However, there are no studies in the literature directly comparing IPACK and genicular blocks. With this study, the investigators aim to compare the efficacy of these two blocks in patients undergoing TKA.

Conditions

  • Postoperative Pain Management in Total Knee Arthroplasty

Interventions

PROCEDURE

IPACK block

After the general anesthesia induction, IPACK block will be performed with 0.25% bupivacaine (20 mL) using ultrasound in addition to adductor canal block.

PROCEDURE

Genicular nerve block with bupivacaine

After the general anesthesia induction, genicular block will be performed with 0.25% bupivacaine (20 mL) using ultrasound in addition to adductor canal block.

Sponsors & Collaborators

  • Kocaeli University

    lead OTHER

Principal Investigators

  • Hadi Ufuk Yörükoğlu · Kocaeli University

Study Design

Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Model
PARALLEL

Eligibility

Min Age
18 Years
Max Age
70 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2025-09-15
Primary Completion
2026-03-15
Completion
2026-04-01

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07171931 on ClinicalTrials.gov