Comparing two nerve-block combinations to reduce pain after total knee replacement

Comparison of Distal IPACK and Popliteal Plexus Block Combined With Femoral Triangle Block After Total Knee Arthroplasty

NA · Karaman Training and Research Hospital · NCT07130552

This test compares whether adding a distal IPACK block or a popliteal plexus block to a femoral triangle block reduces pain after total knee replacement.

Quick facts

PhaseNA
Study typeInterventional
Enrollment120 (estimated)
Ages18 Years to 85 Years
SexAll
SponsorKaraman Training and Research Hospital (other)
Locations1 site (Karaman)
Trial IDNCT07130552 on ClinicalTrials.gov

What this trial studies

This interventional trial randomizes patients having total knee arthroplasty under spinal anesthesia to receive a femoral triangle block combined with either a popliteal plexus block (PPB) or a distal IPACK block as part of multimodal analgesia. Postoperative pain scores at rest and with movement, opioid consumption, and early functional outcomes will be recorded to compare analgesic effectiveness. The IPACK involves ultrasound‑guided infiltration between the popliteal artery and the posterior knee capsule and has been linked to lower pain and opioid needs, while PPB is a newer technique targeting posterior knee innervation. The goal is to identify which block combination gives better posterior‑knee pain relief with minimal motor impairment.

Who should consider this trial

Good fit: Adults scheduled for total knee arthroplasty under spinal anesthesia with ASA I–III who can give informed consent are suitable candidates.

Not a fit: Patients with GFR <50 ml/min, daily long‑term opioid use, lower‑extremity neurological disorders, allergy to local anesthetics, or other contraindications to peripheral nerve blocks may not benefit or be eligible.

Why it matters

Potential benefit: If successful, patients could have less postoperative pain, reduced opioid use, and faster functional recovery after knee replacement.

How similar studies have performed: IPACK has been associated with reduced postoperative pain and opioid consumption in prior work, whereas the popliteal plexus block is promising but lacks head‑to‑head comparison with distal IPACK.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Patients undergoing total knee arthroplasty under spinal anesthesia
* American Society of Anesthesiologists (ASA) status I-III
* Patients who give informed consent

Exclusion Criteria:

* Patients unable to cooperate
* Kidney disease with GFR \< 50 ml/min
* Daily opioid consumption \> 1 month
* Allergy to local anesthetics
* Neurological problems of the lower extremity
* Contraindications to peripheral nerve blocks

Where this trial is running

Karaman

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.

View on ClinicalTrials.gov →

Conditions: Osteo Arthritis of the Knee, Total knee arthroplasty, popliteal plexus block, femoral triangle block, iPACK block

Last reviewed 2026-05-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.