Postoperative Pain Management in Total Knee ArthroplastyNCT07171931
Genicular vs IPACK Block for Analgesia in Knee Arthroplasty
A study testing IPACK block and Genicular nerve block with bupivacaine in people with Postoperative Pain Management in Total Knee Arthroplasty, run by Kocaeli University.
Trial 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. Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Postoperative Pain Management in Total Knee Arthroplasty
- What is being tested?
- IPACK block and Genicular nerve block with bupivacaine
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 72 participants
- Where
- No sites listed yet
- Study dates
- 15 Sep 2025to 1 Apr 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients undergoing unilateral total knee arthroplasty
- ASA physical status I-III
Who cannot join
- BMI > 35
- Patients < 50 kg
- Allergy to study medications
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Comparison of the Postoperative Analgesic Efficacy of Genicular Block and IPACK Block in Addition to Adductor Canal Block in Knee Arthroplasty
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.
Read more
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.
- Being tested
- IPACK block, Genicular nerve block with bupivacaine
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
IPACK blockProcedure or surgery
After the general anesthesia induction, IPACK block will be performed with 0.25% bupivacaine (20 mL) using ultrasound in addition to adductor canal block.
Genicular nerve block with bupivacaineProcedure or surgery
After the general anesthesia induction, genicular block will be performed with 0.25% bupivacaine (20 mL) using ultrasound in addition to adductor canal block.
| Study group | Role | What they receive |
|---|---|---|
| IPACK Group | Active comparator | Patients who will receive IPACK block Receives: Procedure: IPACK block |
| Genicular Group | Active comparator | Patients who will receive genicular block Receives: Procedure: Genicular nerve block with bupivacaine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Morphine consumption
Amount of morphine in the postoperative period (mg)
Measured: Postoperative day 1 (24th hour)
Secondary outcomes (4)
NRS Scores
Numeric Rating Scale scores, between 0-10 (0= no pain, 10=worst pain imaginable)
Measured: Postoperative day 1 (1st, 6th, 12th and 24th hour)
QoR-15
Quality of Recovery-15: 15-item questionnaire that assesses patients' overall quality of recovery, between 0-150.
Measured: Postoperative 12th day
Nausea-vomiting
Number of patients who has nausea or vomiting
Measured: Postoperative day 1
Rescue analgesic
The use of rescue analgesic
Measured: Postoperative day 1
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Sep 2025
- Study start15 Sep 2025 (estimated)
- Primary completion15 Mar 2026 (estimated)
- Study completion1 Apr 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Postoperative Pain Management in Total Knee ArthroplastyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Outcomes assessor
- Enrolment
- 72 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Kocaeli University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hadi Ufuk Yörükoğlu, Kocaeli University
- Investigators
- Hadi Ufuk Yörükoğlu, Principal investigator, Kocaeli University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07171931
- Sponsor's protocol ID
- KAD-FR-42
- Status last verified
- Sep 2025
- First submitted
- 27 Aug 2025
- Last updated
- 15 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Postoperative Analgesic Efficacy of Genicular Block and IPACK Block in Addition to Adductor Canal Block in Knee Arthroplasty
- ClinicalTrials.gov ID
- NCT07171931
- Acronym / sponsor ID
- KAD-FR-42
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 72 participants (estimated)
- Lead sponsor
- Kocaeli UniversityUniversity, hospital or other
- Study start
- 15 Sep 2025 (estimated)
- Primary completion
- 15 Mar 2026 (estimated)
- Study completion
- 1 Apr 2026 (estimated)
- First posted
- 15 Sep 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| IPACK Group | Active comparator | Procedure: IPACK blockPatients who will receive IPACK block |
| Genicular Group | Active comparator | Procedure: Genicular nerve block with bupivacainePatients who will receive genicular block |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Patients undergoing unilateral total knee arthroplasty
- ASA physical status I-III
Key exclusion criteria (3 listed)
- BMI > 35
- Patients < 50 kg
- Allergy to study medications
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| IPACK blockAfter the general anesthesia induction, IPACK block will be performed with 0.25% bupivacaine (20 mL) using ultrasound in addition to adductor canal block. | Procedure or surgery | IPACK Group |
| Genicular nerve block with bupivacaineAfter the general anesthesia induction, genicular block will be performed with 0.25% bupivacaine (20 mL) using ultrasound in addition to adductor canal block. | Procedure or surgery | Genicular Group |
Primary outcome
Morphine consumption
Time frame: Postoperative day 1 (24th hour)
Amount of morphine in the postoperative period (mg)
4 secondary outcomes
NRS Scores
Time frame: Postoperative day 1 (1st, 6th, 12th and 24th hour)
QoR-15
Time frame: Postoperative 12th day
Nausea-vomiting
Time frame: Postoperative day 1
Rescue analgesic
Time frame: Postoperative day 1
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Sep 2025.
- Individual participant dataSharing planned: No
Related trials for Postoperative Pain Management in Total Knee Arthroplasty
Not yet recruiting
Opioid Reduction and Enhanced Recovery in Orthopaedic Surgery (OREOS)-Knee
Knee Arthroplasty, Total, Partial Knee Arthroplasty
Recruiting
Postoperative Delirium and Analgesia in Elderly Patients
Postoperative Delirium, Postoperative Pain, Acute
Not yet recruiting
A Randomized Comparison of the Efficacy of the IPACK Block Versus the Popliteal Plexus Block for Posterior Knee Analgesia, in Patients Undergoing a Total Knee Arthroplasty and Receiving a Continuous Distal Femoral Triangle Block
Osteoarthritis, Knee, Postoperative Pain
RecruitingPhase 3
Suzetrigine in TKA
Total Knee Arthroplasty (TKA), Total Knee Arthroplasty \(TKA\)
Not yet recruiting
Continuous Adductor Canal Block (CACB) Combined With İnfiltration Between the Popliteal Artery and Capsule of the Knee (iPACK) Block vs Continuous Adductor Canal Block Alone After Total Knee Arthroplasty
Total Knee Arthroplasty, Postoperative Pain
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Hadi Ufuk Yörükoğlu principal investigator
Kocaeli University
Questions about this trial
What is this clinical trial studying?
A study testing IPACK block and Genicular nerve block with bupivacaine in people with Postoperative Pain Management in Total Knee Arthroplasty, run by Kocaeli University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 15 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Hadi Ufuk Yörükoğlu (+902623038248, ufukyorukoglu@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Morphine consumption (time frame: Postoperative day 1 (24th hour)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2025.