Ultrasound-Guided Adductor Canal Block versus Combined Adductor Canal and Infiltration between the Popliteal Artery and the Posterior Capsule of the Knee Block for Osteoarthritis Knee Pain

CONTEXT: Minimally invasive therapeutic modalities have been used to relieve refractory pain of knee osteoarthritis (OA). OBJECTIVE: The main objective of the study was to compare the adductor canal block (ACB) with combined ACB and infiltration between the popliteal artery and the posterior capsule of the knee (I-PACK) in patients suffering knee OA pain. PATIENTS AND METHODS: Fifty-six patients were randomly allocated into two equal groups: Group I received ultrasound-guided ACB with 10 mL of 0.125 bupivacaine plus 40 mg methylprednisolone And Group II received ultrasound-guided ACB with 10 mL of 0.125 bupivacaine plus 40 mg methylprednisolone and I-PACK block using same volume and concentration as ACB. RESULTS: Group II showed a statistically significant lower value of visual analog and Western Ontario and McMaster Universities scores at all follow-up intervals compared to Group I. CONCLUSION: Combined ACB and I-PACK block provide more effective analgesia and better functional outcome compared to the ACB alone.