The Effect of Femoral Nerve Block Versus Adductor Canal Block on the Quality of early Recovery after Revision Total Knee Arthroplasty, a retrospective Study

Background Multimodal pain analgesia strategies are common in perioperative management of total knee arthroplasty (TKA), although the role of adductor canal blocks (ACB) versus femoral nerve block on early postoperative recovery for revision knee surgery is not investigated. Aim The purpose of this study is to independently evaluate the effect of ACB on short-term postoperative outcomes including (1) length of stay (LOS), (2) postoperative narcotic utilization, and (3) function with physical therapy in revision TKA. Methods We retrospectively identified a cohort study of consecutive 40 patients from January 2021 to July 2021 who had undergone unilateral revision TKA using a single-shot ACB (19 patients) vs femoral nerve block (21 patients) under spinal anesthesia ( hyperbaric 0.5% Marcaine 2.5 ml and 20 microgram fentanyl) in addition to a standardized multimodal pain analgesia protocol. These 2 groups were compared using independent sample t-tests with primary end points of interest being distance ambulated after surgery, and inpatient narcotic use. Results Quadriceps strength was better preserved in adductor group than in femoral group. Walking meters and going upstairs were better results in adductor group. IV morphine consumption within the first 48 hours period were less in adductor group comparing to femoral group. Conclusion Adductor nerve block showed better early recovery in revision TKA when comparing to femoral nerve block (FNB).