Knee Arthroplasty, TotalNCT07418307
Comparison Between Combined Biceps Femoris Short Head Block and Adductor Canal Block Versus Genicular Nerve Block
A study testing Combined biceps femoris short head block and adductor canal block and Genicular nerve block in people with Knee Arthroplasty, Total, run by Zagazig University at 1 site in Egypt.
Trial summary
The purpose of this study is to compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption, and pain scores) following total knee arthroplasty by either combined biceps femoris short head block and adductor canal block or genicular nerve block in elderly patients. Read more about this study
- Who is it for?
- Ages 65 years and older
- Conditions the study is for
- Knee Arthroplasty, Total
- What is being tested?
- Combined biceps femoris short head block and adductor canal block and Genicular nerve block
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 siteEgypt
- Study dates
- 15 Feb 2026to 15 Nov 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 65 years and older
- All sexes
- No healthy volunteers
- Older adult
Who may be able to join
- patient acceptance
- Physical status: ASA I, II and Ⅲ.
- Body mass index (BMI): 18.5 - 35 kg/m2.
- Type of operations: total knee arthroplasty.
Who cannot join
- Known hypersensitivity to dexamethasone or bupivacaine.
- Coagulation disorders or taking drugs affect surgical hemostasis.
- Patients with pre-existing neurological deficits.
- Uncooperative patient or with altered mental status.
- Patient with advanced cardiovascular or respiratory diseases or uncontrolled diabetes
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site
Faculty of Medicine,Zagazig University
Zagazig
Marwa M Medhat, M.D, 01002828937, medhatmarwa9@gmail.com
About this study
Official title: Enhanced Analgesia in Elderly After Total Knee Arthroplasty Using Combined Biceps Femoris Short Head Block and Adductor Canal Block Versus Genicular Nerve Block
The purpose of this study is to compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption, and pain scores) following total knee arthroplasty by either combined biceps femoris short head block and adductor canal block or genicular nerve block in elderly patients.
- Conditions
- Knee Arthroplasty, Total
- Being tested
- Combined biceps femoris short head block and adductor canal block, Genicular nerve block
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Combined biceps femoris short head block and adductor canal blockOther
Adductor Canal Block high-frequency probe will be placed transversely on the anterior thigh midpoint between inguinal crease and medial condyle (depth 3-5 cm). The needle will be advanced in-plane from lateral to medial through sartorius or vastus medialis muscle toward the femoral artery. Then (10 ml of 0.25% bupivacaine and 2 mg dexamethasone) will be injected after negative aspiration, with confirming spread around the artery without vascular puncture.
Biceps femoris short head block The probe will be placed on the distal posterior thigh to visualize biceps femoris muscle near the lateral supracondylar line of the femur. The needle will be inserted to the interface between biceps femoris and femur cortex. Then (25 ml of 0.25% bupivacaine and 2 mg dexamethasone), with observing muscle lift and circumferential spread along the bone surface .
Genicular nerve blockOther
Position the patient will be placed in supine position with the knee slightly flexed via a pillow in the popliteal fossa. Use a high-frequency linear ultrasound transducer.
Superolateral genicular nerve (SLGN): the transducer will be placed coronally over lateral femoral epicondyle, with sliding proximally to femur metaphysis; identifying artery between vastus lateralis fascia and bone.
Superomedial genicular nerve (SMGN): the transducer will be placed coronally over medial femoral epicondyle, proximal to adductor tubercle at femur metaphysis; artery between vastus medialis fascia and bone.
Inferomedial genicular nerve (IMGN): the transducer will be placed coronally over medial tibial condyle, distal to metaphysis; artery beneath medial collateral ligament.
- Inferolateral genicular nerve (ILGN, optional): the transducer will be placed coronally over lateral tibial epicondyle to fibula head; artery between collateral ligament and tibia
| Study group | Role | What they receive |
|---|---|---|
| Group (C) | Active comparator | The patient will receive combined biceps femoris short head block and adductor canal block Receives: Other: Combined biceps femoris short head block and adductor canal block |
| Group(G) | Active comparator | The patient will receive genicular nerve block Receives: Other: Genicular nerve block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time of first rescue analgesia (naluphine)
to the duration from the block to the moment when the patient first requires or requests supplemental nalbuphine due to breakthrough pain
Measured: 24 hours postoperative
Secondary outcomes (6)
block performance time
time refers to the duration required to prepare, image (e.g., via ultrasound), insert the needle, and inject local anesthetic to complete a regional nerve block procedure.
Measured: time of performance of the block
Pain intensity
10-point NRS [(0 = no pain, 10 = worst imaginable pain), 1-3: Mild pain (nagging, annoying, slightly interfering with activities of daily living (ADLs), 4 - 6: Moderate pain (significantly interfering with ADLs, 7 - 10: Severe pain (disabling, unable to perform ADLs)
Measured: 30 minutesn2, 4, 8, 12, 18 , and 24 hours postoperative
Total amount of rescue analgesia (nalbuphine)
the cumulative dose of nalbuphine administered as supplemental pain relief during a defined postoperative observation period, typically when pain scores exceed a predefined threshold like NRS ≥4
Measured: first 24 hours postoperative
assess functional recovery
(knee range of motion active flexion /extension,
Measured: at 12 hours and 24 hours postoperative
patient's satisfaction
The patients will be asked to rate the overall degree of satisfaction of the analgesia by using a 5-points likert-like verbal scale (1 = very dissatisfied analgesia, 2 = dissatisfied analgesia, and 3 = neutral, 4=satisfied analgesia, and 5=very satisfied analgesia)
Measured: 24 hours postoperative
Block related complications
(motor weakness, hematoma, local anesthetic toxicity,..)
Measured: 24 hours postoperative
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Feb 2026
- Study start15 Feb 2026 (estimated)
- Primary completion15 Aug 2026 (estimated)
- Study completion15 Nov 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Knee Arthroplasty, TotalStudies of the same condition, open and under way.
- More trials run by Zagazig UniversityThe sponsor's other registered studies.
- 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
- Double blind
- Who is masked
- Participant, Care provider
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Zagazig University
- Sponsor type
- Other government
- Responsible party
- Principal investigator, Marwa Mohamed Medhat, Zagazig University
- Investigators
- Howida A Kamal, M.D, Study director, faculty of medicine,zagazig university Egypt
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07418307
- Sponsor's protocol ID
- ZU-IRB#2002/28-Jan-2026
- Status last verified
- Feb 2026
- First submitted
- 4 Feb 2026
- Last updated
- 18 Feb 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
You D, Qin L, Li K, Li D, Zhao G, Li L. A meta-analysis on advantages of peripheral nerve block post-total knee arthroplasty. Korean J Pain. 2021 Jul 1;34(3):271-287. doi: 10.3344/kjp.2021.34.3.271.
PubMed 34193634
Study at a glance
From the registry record, last updated by the sponsor on 18 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Enhanced Analgesia in Elderly After Total Knee Arthroplasty Using Combined Biceps Femoris Short Head Block and Adductor Canal Block Versus Genicular Nerve Block
- ClinicalTrials.gov ID
- NCT07418307
- Acronym / sponsor ID
- ZU-IRB#2002/28-Jan-2026
- Conditions
- Knee Arthroplasty, Total
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- Zagazig UniversityOther government
- Study start
- 15 Feb 2026 (estimated)
- Primary completion
- 15 Aug 2026 (estimated)
- Study completion
- 15 Nov 2026 (estimated)
- First posted
- 18 Feb 2026 (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.
The purpose of this study is to compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption, and pain scores) following total knee arthroplasty by either combined biceps femoris short head block and adductor canal block or genicular nerve block in elderly patients.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group (C) | Active comparator | Other: Combined biceps femoris short head block and adductor canal blockThe patient will receive combined biceps femoris short head block and adductor canal block |
| Group(G) | Active comparator | Other: Genicular nerve blockThe patient will receive genicular nerve block |
Who may qualify
- Ages
- 65 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Older adult
Key inclusion criteria (4 listed)
- patient acceptance
- Physical status: ASA I, II and Ⅲ.
- Body mass index (BMI): 18.5 - 35 kg/m2.
- Type of operations: total knee arthroplasty.
Key exclusion criteria (5 listed)
- Known hypersensitivity to dexamethasone or bupivacaine.
- Coagulation disorders or taking drugs affect surgical hemostasis.
- Patients with pre-existing neurological deficits.
- Uncooperative patient or with altered mental status.
- Patient with advanced cardiovascular or respiratory diseases or uncontrolled diabetes
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 |
|---|---|---|
| Combined biceps femoris short head block and adductor canal blockAdductor Canal Block high-frequency probe will be placed transversely on the anterior thigh midpoint between inguinal crease and medial condyle (depth 3-5 cm). The needle will be advanced in-plane from lateral to medial through sartorius or vastus medialis muscle toward the femoral artery. Then (10 ml of 0.25% bupivacaine and 2 mg dexamethasone) will be injected after negative aspiration, with confirming spread around the artery without vascular puncture. Biceps femoris short head block The probe will be placed on the distal posterior thigh to visualize biceps femoris muscle near the lateral supracondylar line of the femur. The needle will be inserted to the interface between biceps femoris and femur cortex. Then (25 ml of 0.25% bupivacaine and 2 mg dexamethasone), with observing muscle lift and circumferential spread along the bone surface . | Other | Group (C) |
| Genicular nerve blockPosition the patient will be placed in supine position with the knee slightly flexed via a pillow in the popliteal fossa. Use a high-frequency linear ultrasound transducer. Superolateral genicular nerve (SLGN): the transducer will be placed coronally over lateral femoral epicondyle, with sliding proximally to femur metaphysis; identifying artery between vastus lateralis fascia and bone. Superomedial genicular nerve (SMGN): the transducer will be placed coronally over medial femoral epicondyle, proximal to adductor tubercle at femur metaphysis; artery between vastus medialis fascia and bone. Inferomedial genicular nerve (IMGN): the transducer will be placed coronally over medial tibial condyle, distal to metaphysis; artery beneath medial collateral ligament. • Inferolateral genicular nerve (ILGN, optional): the transducer will be placed coronally over lateral tibial epicondyle to fibula head; artery between collateral ligament and tibia | Other | Group(G) |
Primary outcome
Time of first rescue analgesia (naluphine)
Time frame: 24 hours postoperative
to the duration from the block to the moment when the patient first requires or requests supplemental nalbuphine due to breakthrough pain
6 secondary outcomes
block performance time
Time frame: time of performance of the block
Pain intensity
Time frame: 30 minutesn2, 4, 8, 12, 18 , and 24 hours postoperative
Total amount of rescue analgesia (nalbuphine)
Time frame: first 24 hours postoperative
assess functional recovery
Time frame: at 12 hours and 24 hours postoperative
patient's satisfaction
Time frame: 24 hours postoperative
Block related complications
Time frame: 24 hours postoperative
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 18 Feb 2026.
- Background: PubMed 34193634You D, Qin L, Li K, Li D, Zhao G, Li L. A meta-analysis on advantages of peripheral nerve block post-total knee arthroplasty. Korean J Pain. 2021 Jul 1;34(3):271-287. doi: 10.3344/kjp.2021.34.3.271.
- Individual participant dataSharing planned: Undecided
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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.
Howida A Kamal, M.D study director
faculty of medicine,zagazig university Egypt
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Combined biceps femoris short head block and adductor canal block and Genicular nerve block in people with Knee Arthroplasty, Total, run by Zagazig University at 1 site in Egypt.
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 5 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 18 Feb 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 Egypt. 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. 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 Marwa M Medhat, M.D (01002828937, medhatmarwa9@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time of first rescue analgesia (naluphine) (time frame: 24 hours postoperative). 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 NCT07418307, which also lists 1 linked publication.
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 18 Feb 2026.