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Postoperative Pain Management in Total Knee ArthroplastyNCT07191964

Efficacy of an AFCN Proxy Block in Post-TKA Multimodal Pain Management

A study testing Supra-Sartorial Subcutaneous Infiltration (SSSI), intermittent adductor canal block (iACB) and posterior capsule local infiltration analgesia (PC-LIA) in people with Postoperative Pain Management in Total Knee Arthroplasty, run by Taipei Medical University WanFang Hospital at 1 site in Taiwan.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This randomized controlled trial evaluates the additive effect of Supra-Sartorial Subcutaneous Infiltration (SSSI) when performed in combination with intermittent adductor canal block (iACB) and posterior capsule local infiltration analgesia (PC-LIA) for pain management after total knee arthroplasty (TKA). Read more about this study

Who is it for?
Ages 45 to 90 years
What is being tested?
Supra-Sartorial Subcutaneous Infiltration (SSSI), intermittent adductor canal block (iACB) and posterior capsule local infiltration analgesia (PC-LIA)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
90 participants
Where
1 siteTaiwan
Study dates
1 Aug 2026to 1 Sep 2027
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 45 to 90 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults aged 45-90 undergoing unilateral primary TKA for osteoarthritis.
  • American Society of Anesthesiologists (ASA) physical status I-III.
  • Able to provide informed consent and use NRS pain scales.
  • Surgery scheduled to start before noon to standardize spinal anesthesia recovery.

Who cannot join

  • Bilateral or revision TKA.
  • Contraindications to regional anesthesia (e.g., coagulopathy, infection at injection site).
  • Chronic opioid use (>30 mg morphine equivalents/day) or preoperative NRS >4.
  • Pre-existing neurological deficits in lower extremities or AFCN-related neuropathy.
  • Allergy to ropivacaine.
  • Pregnancy, breastfeeding, or cognitive impairment affecting assessments.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Shang-Ru Yeoh, MD, MSc contact

+886-987-850-411

sr.yeoh@gmail.com

Taiwan1 site
  • Taipei Municipal Wanfang Hospital

    Taipei, 116

Other trials in Taiwan

About this study

Official title: Efficacy Assessment of Supra-Sartorial Subcutaneous Infiltration (SSSI) as an Anterior Femoral Cutaneous Nerve Proxy Block in the Multimodal Pain Management After Total Knee Arthroplasty: A Randomized Controlled Trial

This randomized controlled trial evaluates the additive effect of Supra-Sartorial Subcutaneous Infiltration (SSSI) when performed in combination with intermittent adductor canal block (iACB) and posterior capsule local infiltration analgesia (PC-LIA) for pain management after total knee arthroplasty (TKA). SSSI, an easy-to-perform tentative proxy block to targeted anterior femoral cutaneous nerve (AFCN) block, is tested in 90 adults (45-90 years) randomized into two arms: active SSSI versus sham SSSI. Primary outcome is pain scores at rest and during movement on postoperative day 0; secondary outcomes include daily pain trajectory at rest and during movement, functional recovery scores, rescue analgesic doses over days 0-3, and quality of recovery assessment on day 4.

Read the detailed description

This prospective, double-blinded, sham-controlled randomized controlled trial investigates the additive analgesic effect of Supra-Sartorial Subcutaneous Infiltration (SSSI) when combined with intermittent adductor canal block (iACB) and posterior capsule local infiltration analgesia (PC-LIA) following total knee arthroplasty (TKA). The SSSI technique was developed as a simplified, practical alternative to the technically demanding targeted anterior femoral cutaneous nerve (AFCN) block. Drawing on preliminary data where SSSI provided clinically meaningful analgesia in approximately 58% of patients when paired with PC-LIA, this trial evaluates the role of SSSI in enhancing motor-sparing analgesia within a multimodal framework. The study will enroll 90 adults between the ages of 45 and 90 undergoing unilateral primary TKA. Participants will be randomized 1:1 into two groups of 45, with stratification based on gender and baseline Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. All active interventions utilize 0.3% ropivacaine, while the control arm utilizes saline shams for the SSSI component. The SSSI and iACB catheterizations are performed by anesthesiologists in the post-anesthesia care unit, whereas the PC-LIA is administered intraoperatively by the surgical team. Patients in the active group receive active SSSI, active iACB, and active PC-LIA, while those in the sham group receive a saline SSSI alongside active iACB and active PC-LIA. The primary outcome is defined as Visual Analog Scale (VAS) pain scores at rest and during movement at 9:00 PM on postoperative day 0. Secondary outcomes include daily VAS pain scores at rest and during functional assessments such as continuous passive motion (CPM) and the timed up-and-go (TUG) test through postoperative day 1-4. Additionally, the trial monitors the maximal allowable degree of CPM, TUG test performance, cumulative rescue analgesic doses over the first 4 postoperative days, and Quality of Recovery-15 (QoR-15) scores on postoperative day 4. With approximately 96% power to detect a 2-point difference in pain scores, the trial aims to determine if SSSI significantly improves postoperative analgesia without compromising motor function.

Being tested
Supra-Sartorial Subcutaneous Infiltration (SSSI), intermittent adductor canal block (iACB), posterior capsule local infiltration analgesia (PC-LIA)
Keywords
Anterior Femoral Cutaneous Nerve Block, Total Knee Arthroplasty

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Supra-Sartorial Subcutaneous Infiltration (SSSI)Procedure or surgery

    20 mL Ropivacaine or saline infiltrated subcutaneously from lateral to medial, superficial to vastus medialis and sartorius muscle, at femoral triangle apex using inject-as-you-advance technique, avoiding hyperechoic nerves.

  • intermittent adductor canal block (iACB)Procedure or surgery

    A single-shot adductor canal block is first performed post-operatively with 20 mL 0.3% Ropivacaine at the level of femoral triangle apex before inserting a catheter into the canal. The following doses (20 mL each time) start at 9:00 PM on the day of surgery and are intermittently given every 12 hours until day 4.

  • posterior capsule local infiltration analgesia (PC-LIA)Procedure or surgery

    PC-LIA consists of two 10 mL injections of 0.3% ropivacaine delivered intraoperatively to the posteromedial and posterolateral aspects of the posterior capsule before cementation. The target injection plane is the potential space between the posterior capsule and the popliteal artery.

Study groups in NCT07191964
Study groupRoleWhat they receive
SSSI (active) + iACB and PC-LIAActive comparatorNot described
Receives: Procedure: Supra-Sartorial Subcutaneous Infiltration (SSSI); Procedure: intermittent adductor canal block (iACB); Procedure: posterior capsule local infiltration analgesia (PC-LIA)
SSSI (sham) + iACB and PC-LIAPlacebo comparatorNot described
Receives: Procedure: Supra-Sartorial Subcutaneous Infiltration (SSSI); Procedure: intermittent adductor canal block (iACB); Procedure: posterior capsule local infiltration analgesia (PC-LIA)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain: VAS at rest and during movement on postoperative day 0

    VAS pain scores at rest and during continuous passive motion will be taken on postoperative day 0 at 9 PM. Higher VAS pain scores indicate worse pain levels.

    Measured: at 9 PM on postoperative day 0

Secondary outcomes (6)
  1. Pain: VAS at rest and during movement from postoperative day 1-4

    VAS pain scores will be taken at rest and during CPM and TUG test on postoperative day 1 (6 AM, 6 PM), POD 2 (6 AM, 6 PM), POD 3 (6 AM, 6 PM), and POD 4 (6 AM). Higher VAS pain scores indicate worse pain levels.

    Measured: From postoperative day 1 at 6 AM to postoperative day 4 at 6 AM.

  2. Rescue ACB doses (0.3% ropivacaine, mg)

    Rescue ACB will be administered via catheter as needed outside of the scheduled doses (from postoperative day 0 at 9 PM to postoperative day 4 at 6 AM, q12 hours).

    Measured: From the time discharging from post-anesthesia care unit to postoperative day 4 at 6 AM

  3. Additional morphine doses (mg)

    Intravenous morphine as bolus or patient-controlled analgesia may be administered as needed if regional anesthesia fails to provide adequate analgesia (VAS pain <4).

    Measured: From the time discharging from post-anesthesia care unit to postoperative day 4 at 6 AM

  4. Functional: TUG test

    Daily TUG test will be performed from postoperative day 1 at 6 AM to postoperative day 4 at 6 AM, q24 hours. TUG test is measuted in seconds, with higher values indicating poorer functional recovery.

    Measured: From postoperative day 1 at 6 AM to postoperative day 4 at 6 AM.

  5. Functional: CPM maximal allowable angle

    CPM maximal allowable angle will be increased q24 hours according to patient's tolerance from day 0 at 9 PM to day 3 at 6 PM. CPM angle is measured in degree, with higher values indicating better postoperative recovery.

    Measured: From postoperative day 0 at 9 PM to day 3 at 6 PM.

  6. Quality of Recovery

    Quality of Recovery-15 (QoE-15) scores will be taken on postoperative day 4 at 6 AM. Value range 0-150, with higher scores indicating better recovery.

    Measured: At postoperative day 4 at 6 AM.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Sep 2025
  2. Study start1 Aug 2026 (estimated)
  3. Primary completion1 Aug 2027 (estimated)
  4. Study completion1 Sep 2027 (estimated)

Resources

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
Double blind
Who is masked
Participant, Care provider
Enrolment
90 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07191964
Sponsor's protocol ID
N202511018
Status last verified
May 2026
First submitted
10 Sep 2025
Last updated
1 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Yeoh SR, Chang WC, Wang KL, Tai KY, Hsu FK, Chuang CW. Supra-Sartorial Subcutaneous Infiltration (SSSI) for Anterior Femoral Cutaneous Nerve Coverage in Total Knee Arthroplasty: A Preliminary Clinical Study. Biomedicines. 2025 Sep 27;13(10):2368. doi: 10.3390/biomedicines13102368.

    PubMed 41153655
  • Kampitak W, Tanavalee A, Tansatit T, Ngarmukos S, Songborassamee N, Vichainarong C. The analgesic efficacy of anterior femoral cutaneous nerve block in combination with femoral triangle block in total knee arthroplasty: a randomized controlled trial. Korean J Anesthesiol. 2021 Dec;74(6):496-505. doi: 10.4097/kja.21120. Epub 2021 Jun 29.

    PubMed 34182749
  • Pivec C, Bodner G, Mayer JA, Brugger PC, Paraszti I, Moser V, Traxler H, Riegler G. Novel Demonstration of the Anterior Femoral Cutaneous Nerves using Ultrasound. Ultraschall Med. 2018 Feb 7. doi: 10.1055/s-0043-121628. Online ahead of print.

    PubMed 29415312
  • Bjorn S, Nielsen TD, Jensen AE, Jessen C, Kolsen-Petersen JA, Moriggl B, Hoermann R, Bendtsen TF. The Anterior Branch of the Medial Femoral Cutaneous Nerve Innervates Cutaneous and Deep Surgical Incisions in Total Knee Arthroplasty. J Clin Med. 2024 May 31;13(11):3270. doi: 10.3390/jcm13113270.

    PubMed 38892981
  • Bjorn S, Nielsen TD, Jensen AE, Jessen C, Kolsen-Petersen JA, Moriggl B, Hoermann R, Nyengaard JR, Bendtsen TF. The anterior branch of the medial femoral cutaneous nerve innervates the anterior knee: a randomized volunteer trial. Minerva Anestesiol. 2023 Jul-Aug;89(7-8):643-652. doi: 10.23736/S0375-9393.22.16910-5. Epub 2023 Feb 27.

    PubMed 36852567
  • Bjorn S, Nielsen TD, Moriggl B, Hoermann R, Bendtsen TF. Anesthesia of the anterior femoral cutaneous nerves for total knee arthroplasty incision: randomized volunteer trial. Reg Anesth Pain Med. 2019 Dec 10:rapm-2019-100904. doi: 10.1136/rapm-2019-100904. Online ahead of print.

    PubMed 31826920

Questions about this trial

What is this clinical trial studying?

A study testing Supra-Sartorial Subcutaneous Infiltration (SSSI), intermittent adductor canal block (iACB) and posterior capsule local infiltration analgesia (PC-LIA) in people with Postoperative Pain Management in Total Knee Arthroplasty, run by Taipei Medical University WanFang Hospital at 1 site in Taiwan.

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 4 inclusion and 6 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 1 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. 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 Shang-Ru Yeoh, MD, MSc (+886-987-850-411, sr.yeoh@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain: VAS at rest and during movement on postoperative day 0 (time frame: at 9 PM on postoperative day 0). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07191964, which also lists 6 linked publications.

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 1 Jul 2026.

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