Efficacy of interspace between the popliteal artery and the capsule of the posterior knee (iPACK) block versus periarticular local infiltration analgesia after unilateral total knee arthroplasty: Prospective randomized control trial

Abdul Sattar Narejo; Fatima Abdulwahab; Mansoor Aqil; Abdullah T. Alsubaie; Hassan Y. Hazazy; Tariq Alzahrani; Abdulaziz Aljurayyan; Ahmed Thallaj

doi:10.15537/smj.2021.42.10.20210504

References

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1. Fransen BL,
2. Hoozemans MJM,
3. Argelo KDS,
4. Keijser LCM,
5. Burger BJ.
Fast-track total knee arthroplasty improved clinical and functional outcome in the first 7 days after surgery: a randomized controlled pilot study with 5-year follow-up. Arch Orthop Trauma Surg 2018; 138: 1305–1316.
OpenUrl
2.↵
1. Kampitak W,
2. Tanavalee A,
3. Ngarmukos S,
4. Tantavisut S.
Motor-sparing effect of iPACK (interspace between the popliteal artery and capsule of the posterior knee) block versus tibial nerve block after total knee arthroplasty: a randomized controlled trial. Reg Anesth Pain Med 2020; 45: 267–276.
OpenUrl Abstract/FREE Full Text
3.↵
1. Ortiz-Gómez JR,
2. Perepérez-Candel M,
3. Vázquez-Torres JM,
4. Rodriguez-Del Río JM,
5. Torrón-Abad B,
6. Fornet-Ruiz I, et al.
Postoperative analgesia for elective total knee arthroplasty under subarachnoid anesthesia with opioids: comparison between epidural, femoral block, and adductor canal block techniques (with and without perineural adjuvants). A prospective, randomized, clinical trial. Minerva Anestesiol 2017; 83: 50–58.
OpenUrl PubMed
4.
1. Sankineani SR,
2. Reddy ARC,
3. Eachempati KK,
4. Jangale A,
5. Gurava Reddy AV.
Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. Eur J Orthop Surg Traumatol 2018; 28: 1391–1395.
OpenUrl PubMed
5.↵
1. Koh IJ,
2. Choi YJ,
3. Kim MS,
4. Koh HJ,
5. Kang MS,
6. In Y.
Femoral nerve block versus adductor canal block for analgesia after total knee arthroplasty. Knee Surg Relat Res 2017; 29: 87–95.
OpenUrl
6.↵
1. Jiang X,
2. Wang QQ,
3. Wu CA,
4. Tian W.
Analgesic efficacy of adductor canal block in total knee arthroplasty: A meta-analysis and systematic review. Orthop Surg 2016; 8: 294–300.
OpenUrl PubMed
7.
1. Karkhur Y,
2. Mahajan R,
3. Kakralia A,
4. Pandey AP,
5. Kapoor MC.
A comparative analysis of femoral nerve block with adductor canal block following total knee arthroplasty: A systematic literature review. J Anaesthesiol Clin Pharmacol 2018; 34: 433–438.
OpenUrl
8.↵
1. St Laurant DB,
2. Peng P,
3. Arango LG,
4. Niazi AU,
5. Chan VW,
6. Agur A, et al.
The nerves of the adductor canal and the innervation of the knee: an anatomic study. Reg Anesth Pain Med 2016; 41: 321–327.
OpenUrl Abstract/FREE Full Text
9.↵
1. Roberts SL,
2. Stout A,
3. Dreyfuss P.
Review of knee joint innervation: implications for diagnostic blocks and radiofrequency Ablation. Pain Med 2020; 21: 922–938.
OpenUrl
10.↵
1. Fonkoué L,
2. Behets C,
3. Kouassi JK,
4. Coyette M,
5. Detrembleur C,
6. Thienpont E, et al.
Distribution of sensory nerves supplying the knee joint capsule and implications for genicular blockade and radiofrequency ablation: an anatomical study. Surg Radiol Anat 2019; 41: 1461–1471.
OpenUrl PubMed
11.↵
1. Thobhani S,
2. Scalercio L,
3. Elliott CE,
4. Nossaman BD,
5. Thomas LC,
6. Yuratich D, et al.
Novel regional techniques for total knee arthroplasty promote reduced hospital length of stay: An analysis of 106 patients. Ochsner J 2017; 17: 233–238.
OpenUrl Abstract/FREE Full Text
12.↵
1. Kim DH,
2. Beathe JC,
3. Lin Y,
4. YaDeau JT,
5. Maalouf DB,
6. Goytizolo E, et al.
Addition of infiltration between the popliteal artery and the capsule of the posterior knee and adductor canal block to periarticular injection enhances postoperative pain control in total knee arthroplasty: A randomized controlled trial. Anesth Analg 2019; 129: 526–535.
OpenUrl PubMed
13.↵
1. Tran J,
2. Giron Arango L,
3. Peng P,
4. Sinha SK,
5. Agur A,
6. Chan V.
Evaluation of the iPACK block injectate spread: a cadaveric study. Reg Anesth Pain Med 2019: rapm-2018-100355.
14.↵
1. Albrecht E,
2. Wegrzyn J,
3. Dabetic A,
4. El-Boghdadly K.
The analgesic efficacy of iPACK after knee surgery: A systematic review and meta-analysis with trial sequential analysis. J Clin Anesth 2021; 72: 110305.
OpenUrl PubMed
15.↵
1. Ochroch J,
2. Qi V,
3. Badiola I,
4. Grosh T,
5. Cai L,
6. Graff V, et al.
Analgesic efficacy of adding the IPACK block to a multimodal analgesia protocol for primary total knee arthroplasty. Reg Anesth Pain Med 2020; 45: 799–804.
OpenUrl Abstract/FREE Full Text
16.↵
1. Seangleulur A,
2. Vanasbodeekul P,
3. Prapaitrakool S,
4. Worathongchai S,
5. Anothaisintawee T,
6. McEvoy M, et al.
The efficacy of local infiltration analgesia in the early postoperative period after total knee arthroplasty: A systematic review and meta-analysis. Eur J Anaesthesiol 2016; 33: 816–831.
OpenUrl PubMed
17.↵
1. Vora MU,
2. Nicholas TA,
3. Kassel CA,
4. Grant SA.
Adductor canal block for knee surgical procedures: review article. J Clin Anesth 2016; 35: 295–303.
OpenUrl
18.↵
1. O’Donnell R,
2. Dolan J.
Anaesthesia and analgesia for knee joint arthroplasty. BJA Educ 2018; 18: 8–15.
OpenUrl PubMed
19.↵
1. McGinnis RS,
2. Patel S,
3. Silva I,
4. Mahadevan N,
5. DiCristofaro S,
6. Jortberg E, et al.
Skin mounted accelerometer system for measuring knee range of motion. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2016: 5298–5302.
OpenUrl
20.↵
1. Hsieh CY,
2. Huang HY,
3. Liu KC,
4. Chen KH,
5. Hsu SJ,
6. Chan CT.
Subtask segmentation of timed up and go test for mobility assessment of perioperative total knee arthroplasty. Sensors (Basel) 2020; 20: 6302.
OpenUrl
21.↵
1. Jung DW,
2. Shon WY,
3. Seo SS,
4. Kim OG,
5. Lee IS.
Comparison of the postoperative analgesic effect for infiltration between the popliteal artery and the capsule of the posterior knee and that of periarticular multimodal drug injection in total knee arthroplasty: retrospective study in the immediate postoperative period. Knee Surg Relat Res 2020; 32: 1.
OpenUrl PubMed
22.↵
1. Kerr DR,
2. Kohan L.
Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of 325 patients. Acta Orthop 2008; 79: 174–183.
OpenUrl CrossRef PubMed Web of Science
23.↵
1. Liu X,
2. Zhang H,
3. Zhang H,
4. Guo M,
5. Gao Y,
6. Du C.
Local infiltration vs epidural analgesia for postoperative pain control after total knee or hip arthroplasty: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020 30; 99: e22674.
OpenUrl
24.↵
1. Hussain N,
2. Brull R,
3. Sheehy B,
4. Dasu M,
5. Weaver T,
6. Abdallah FW.
Does the addition of iPACK to adductor canal block in the presence or absence of periarticular local anesthetic infiltration improve analgesic and functional outcomes following total knee arthroplasty? A systematic review and meta-analysis. Reg Anesth Pain Med 2021; 46: 713–721.
OpenUrl Abstract/FREE Full Text
25.↵
1. Kampitak W,
2. Tansatit T,
3. Tanavalee A,
4. Ngarmukos S.
Optimal location of local anesthetic injection in the interspace between the popliteal artery and posterior capsule of the knee (iPACK) for posterior knee pain after total knee arthroplasty: an anatomical and clinical study. Korean J Anesthesiol 2019; 72: 486–494.
OpenUrl PubMed

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Keywords

[1] 1.↵
Fransen BL,
Hoozemans MJM,
Argelo KDS,
Keijser LCM,
Burger BJ.
Fast-track total knee arthroplasty improved clinical and functional outcome in the first 7 days after surgery: a randomized controlled pilot study with 5-year follow-up. Arch Orthop Trauma Surg 2018; 138: 1305–1316.
OpenUrl

[2] Fransen BL,

[3] Hoozemans MJM,

[4] Argelo KDS,

[5] Keijser LCM,

[6] Burger BJ.

[7] 2.↵
Kampitak W,
Tanavalee A,
Ngarmukos S,
Tantavisut S.
Motor-sparing effect of iPACK (interspace between the popliteal artery and capsule of the posterior knee) block versus tibial nerve block after total knee arthroplasty: a randomized controlled trial. Reg Anesth Pain Med 2020; 45: 267–276.
OpenUrl Abstract/FREE Full Text

[8] Kampitak W,

[9] Tanavalee A,

[10] Ngarmukos S,

[11] Tantavisut S.

[12] 3.↵
Ortiz-Gómez JR,
Perepérez-Candel M,
Vázquez-Torres JM,
Rodriguez-Del Río JM,
Torrón-Abad B,
Fornet-Ruiz I, et al.
Postoperative analgesia for elective total knee arthroplasty under subarachnoid anesthesia with opioids: comparison between epidural, femoral block, and adductor canal block techniques (with and without perineural adjuvants). A prospective, randomized, clinical trial. Minerva Anestesiol 2017; 83: 50–58.
OpenUrl PubMed

[13] Ortiz-Gómez JR,

[14] Perepérez-Candel M,

[15] Vázquez-Torres JM,

[16] Rodriguez-Del Río JM,

[17] Torrón-Abad B,

[18] Fornet-Ruiz I, et al.

[19] 4.
Sankineani SR,
Reddy ARC,
Eachempati KK,
Jangale A,
Gurava Reddy AV.
Comparison of adductor canal block and IPACK block (interspace between the popliteal artery and the capsule of the posterior knee) with adductor canal block alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. Eur J Orthop Surg Traumatol 2018; 28: 1391–1395.
OpenUrl PubMed

[20] Sankineani SR,

[21] Reddy ARC,

[22] Eachempati KK,

[23] Jangale A,

[24] Gurava Reddy AV.

[25] 5.↵
Koh IJ,
Choi YJ,
Kim MS,
Koh HJ,
Kang MS,
In Y.
Femoral nerve block versus adductor canal block for analgesia after total knee arthroplasty. Knee Surg Relat Res 2017; 29: 87–95.
OpenUrl

[26] Koh IJ,

[27] Choi YJ,

[28] Kim MS,

[29] Koh HJ,

[30] Kang MS,

[31] In Y.

[32] 6.↵
Jiang X,
Wang QQ,
Wu CA,
Tian W.
Analgesic efficacy of adductor canal block in total knee arthroplasty: A meta-analysis and systematic review. Orthop Surg 2016; 8: 294–300.
OpenUrl PubMed

[33] Jiang X,

[34] Wang QQ,

[35] Wu CA,

[36] Tian W.

[37] 7.
Karkhur Y,
Mahajan R,
Kakralia A,
Pandey AP,
Kapoor MC.
A comparative analysis of femoral nerve block with adductor canal block following total knee arthroplasty: A systematic literature review. J Anaesthesiol Clin Pharmacol 2018; 34: 433–438.
OpenUrl

[38] Karkhur Y,

[39] Mahajan R,

[40] Kakralia A,

[41] Pandey AP,

[42] Kapoor MC.

[43] 8.↵
St Laurant DB,
Peng P,
Arango LG,
Niazi AU,
Chan VW,
Agur A, et al.
The nerves of the adductor canal and the innervation of the knee: an anatomic study. Reg Anesth Pain Med 2016; 41: 321–327.
OpenUrl Abstract/FREE Full Text

[44] St Laurant DB,

[45] Peng P,

[46] Arango LG,

[47] Niazi AU,

[48] Chan VW,

[49] Agur A, et al.

[50] 9.↵
Roberts SL,
Stout A,
Dreyfuss P.
Review of knee joint innervation: implications for diagnostic blocks and radiofrequency Ablation. Pain Med 2020; 21: 922–938.
OpenUrl

[51] Roberts SL,

[52] Stout A,

[53] Dreyfuss P.

[54] 10.↵
Fonkoué L,
Behets C,
Kouassi JK,
Coyette M,
Detrembleur C,
Thienpont E, et al.
Distribution of sensory nerves supplying the knee joint capsule and implications for genicular blockade and radiofrequency ablation: an anatomical study. Surg Radiol Anat 2019; 41: 1461–1471.
OpenUrl PubMed

[55] Fonkoué L,

[56] Behets C,

[57] Kouassi JK,

[58] Coyette M,

[59] Detrembleur C,

[60] Thienpont E, et al.

[61] 11.↵
Thobhani S,
Scalercio L,
Elliott CE,
Nossaman BD,
Thomas LC,
Yuratich D, et al.
Novel regional techniques for total knee arthroplasty promote reduced hospital length of stay: An analysis of 106 patients. Ochsner J 2017; 17: 233–238.
OpenUrl Abstract/FREE Full Text

[62] Thobhani S,

[63] Scalercio L,

[64] Elliott CE,

[65] Nossaman BD,

[66] Thomas LC,

[67] Yuratich D, et al.

[68] 12.↵
Kim DH,
Beathe JC,
Lin Y,
YaDeau JT,
Maalouf DB,
Goytizolo E, et al.
Addition of infiltration between the popliteal artery and the capsule of the posterior knee and adductor canal block to periarticular injection enhances postoperative pain control in total knee arthroplasty: A randomized controlled trial. Anesth Analg 2019; 129: 526–535.
OpenUrl PubMed

[69] Kim DH,

[70] Beathe JC,

[71] Lin Y,

[72] YaDeau JT,

[73] Maalouf DB,

[74] Goytizolo E, et al.

[75] 13.↵
Tran J,
Giron Arango L,
Peng P,
Sinha SK,
Agur A,
Chan V.
Evaluation of the iPACK block injectate spread: a cadaveric study. Reg Anesth Pain Med 2019: rapm-2018-100355.

[76] Tran J,

[77] Giron Arango L,

[78] Peng P,

[79] Sinha SK,

[80] Agur A,

[81] Chan V.

[82] 14.↵
Albrecht E,
Wegrzyn J,
Dabetic A,
El-Boghdadly K.
The analgesic efficacy of iPACK after knee surgery: A systematic review and meta-analysis with trial sequential analysis. J Clin Anesth 2021; 72: 110305.
OpenUrl PubMed

[83] Albrecht E,

[84] Wegrzyn J,

[85] Dabetic A,

[86] El-Boghdadly K.

[87] 15.↵
Ochroch J,
Qi V,
Badiola I,
Grosh T,
Cai L,
Graff V, et al.
Analgesic efficacy of adding the IPACK block to a multimodal analgesia protocol for primary total knee arthroplasty. Reg Anesth Pain Med 2020; 45: 799–804.
OpenUrl Abstract/FREE Full Text

[88] Ochroch J,

[89] Qi V,

[90] Badiola I,

[91] Grosh T,

[92] Cai L,

[93] Graff V, et al.

[94] 16.↵
Seangleulur A,
Vanasbodeekul P,
Prapaitrakool S,
Worathongchai S,
Anothaisintawee T,
McEvoy M, et al.
The efficacy of local infiltration analgesia in the early postoperative period after total knee arthroplasty: A systematic review and meta-analysis. Eur J Anaesthesiol 2016; 33: 816–831.
OpenUrl PubMed

[95] Seangleulur A,

[96] Vanasbodeekul P,

[97] Prapaitrakool S,

[98] Worathongchai S,

[99] Anothaisintawee T,

[100] McEvoy M, et al.

[101] 17.↵
Vora MU,
Nicholas TA,
Kassel CA,
Grant SA.
Adductor canal block for knee surgical procedures: review article. J Clin Anesth 2016; 35: 295–303.
OpenUrl

[102] Vora MU,

[103] Nicholas TA,

[104] Kassel CA,

[105] Grant SA.

[106] 18.↵
O’Donnell R,
Dolan J.
Anaesthesia and analgesia for knee joint arthroplasty. BJA Educ 2018; 18: 8–15.
OpenUrl PubMed

[107] O’Donnell R,

[108] Dolan J.

[109] 19.↵
McGinnis RS,
Patel S,
Silva I,
Mahadevan N,
DiCristofaro S,
Jortberg E, et al.
Skin mounted accelerometer system for measuring knee range of motion. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2016: 5298–5302.
OpenUrl

[110] McGinnis RS,

[111] Patel S,

[112] Silva I,

[113] Mahadevan N,

[114] DiCristofaro S,

[115] Jortberg E, et al.

[116] 20.↵
Hsieh CY,
Huang HY,
Liu KC,
Chen KH,
Hsu SJ,
Chan CT.
Subtask segmentation of timed up and go test for mobility assessment of perioperative total knee arthroplasty. Sensors (Basel) 2020; 20: 6302.
OpenUrl

[117] Hsieh CY,

[118] Huang HY,

[119] Liu KC,

[120] Chen KH,

[121] Hsu SJ,

[122] Chan CT.

[123] 21.↵
Jung DW,
Shon WY,
Seo SS,
Kim OG,
Lee IS.
Comparison of the postoperative analgesic effect for infiltration between the popliteal artery and the capsule of the posterior knee and that of periarticular multimodal drug injection in total knee arthroplasty: retrospective study in the immediate postoperative period. Knee Surg Relat Res 2020; 32: 1.
OpenUrl PubMed

[124] Jung DW,

[125] Shon WY,

[126] Seo SS,

[127] Kim OG,

[128] Lee IS.

[129] 22.↵
Kerr DR,
Kohan L.
Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of 325 patients. Acta Orthop 2008; 79: 174–183.
OpenUrl CrossRef PubMed Web of Science

[130] Kerr DR,

[131] Kohan L.

[132] 23.↵
Liu X,
Zhang H,
Zhang H,
Guo M,
Gao Y,
Du C.
Local infiltration vs epidural analgesia for postoperative pain control after total knee or hip arthroplasty: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020 30; 99: e22674.
OpenUrl

[133] Liu X,

[134] Zhang H,

[135] Zhang H,

[136] Guo M,

[137] Gao Y,

[138] Du C.

[139] 24.↵
Hussain N,
Brull R,
Sheehy B,
Dasu M,
Weaver T,
Abdallah FW.
Does the addition of iPACK to adductor canal block in the presence or absence of periarticular local anesthetic infiltration improve analgesic and functional outcomes following total knee arthroplasty? A systematic review and meta-analysis. Reg Anesth Pain Med 2021; 46: 713–721.
OpenUrl Abstract/FREE Full Text

[140] Hussain N,

[141] Brull R,

[142] Sheehy B,

[143] Dasu M,

[144] Weaver T,

[145] Abdallah FW.

[146] 25.↵
Kampitak W,
Tansatit T,
Tanavalee A,
Ngarmukos S.
Optimal location of local anesthetic injection in the interspace between the popliteal artery and posterior capsule of the knee (iPACK) for posterior knee pain after total knee arthroplasty: an anatomical and clinical study. Korean J Anesthesiol 2019; 72: 486–494.
OpenUrl PubMed

[147] Kampitak W,

[148] Tansatit T,

[149] Tanavalee A,

[150] Ngarmukos S.

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Efficacy of interspace between the popliteal artery and the capsule of the posterior knee (iPACK) block versus periarticular local infiltration analgesia after unilateral total knee arthroplasty

Prospective randomized control trial

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Efficacy of interspace between the popliteal artery and the capsule of the posterior knee (iPACK) block versus periarticular local infiltration analgesia after unilateral total knee arthroplasty

Prospective randomized control trial

References

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