Total Knee ArthroplastyLIAQNCT07477730
Local Infiltration Analgesia Versus Quadruple Nerve Blocks in Total Knee Arthroplasty.
A study testing Surgical local infiltration, Obturator nerve block and Femoral nerve block in people with Total Knee Arthroplasty, run by CMC Ambroise Paré at 1 site in France.
Trial summary
Total knee arthroplasty (TKA) is one of the most common orthopedic surgical procedures and is associated with severe pain in the immediate postoperative period, thus limiting early recovery. Optimal postoperative pain management after TKA is not fully defined. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Total Knee Arthroplasty
- What is being tested?
- Surgical local infiltration, Obturator nerve block and Femoral nerve block
- Type of treatment
- Pill or oral medicine, Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 80 participants
- Where
- 1 siteFrance
- Study dates
- 2 Sep 2026to 2 May 2028
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients undergoing primary total knee arthroplasty under general anesthesia (laryngeal mask airway)
- Fully autonomous at home
- Planned discharge to home
- Consent for participation
- Affiliation to a social security system
Who cannot join
- Preoperative opioid use
- Chronic pain syndrome
- Valgus contraindicating sciatic nerve block
- Contraindication to any drugs used in the protocol
- Contraindication to laryngeal mask airway
- Pregnant or breastfeeding women
- Patients under protection of the adults (guardianship, curators or safeguard of justice)
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
France1 site, 1 recruiting
- Recruiting
Clinique Médipôle Garonne
Toulouse, Haute-Garonne, 31036
Clément CHASSERY, MD, 05 62 13 29 97 ext. 33, cchassery@gmail.com
Clément CHASSERY, MD
About this study
Official title: Local Infiltration Analgesia Versus Quadruple Nerve Blocks in Total Knee Arthroplasty: a Randomized Controlled Trial.
Total knee arthroplasty (TKA) is one of the most common orthopedic surgical procedures and is associated with severe pain in the immediate postoperative period, thus limiting early recovery.
Optimal postoperative pain management after TKA is not fully defined. While multimodal analgesia is standard, the choice of associated regional anesthesia techniques is debated.
Read more
Local infiltration analgesia (LIA) is widely used and provides effective pain relief without impairing early mobilization.
Peripheral nerve blocks have been discussed due to the risk of motor blockade, but low-concentration local anesthetics, such as 0.1% ropivacaine, allow sensory blockade while preserving motor function. Preliminary studies suggest that this concentration is effective and safe.
The main objective of this monocenter, prospective, randomized, open-label, controlled trial is to compare the analgesic efficacy of a quadruple nerve blocks (femoral, sciatic, obturator, and lateral femoral cutaneous nerves) using 0.1% ropivacaine versus standard LIA in patients undergoing TKA.
Read the detailed description
In the pre-anaesthesia room, after the implementation of classical monitoring with an oxygen mask and a peripheral venous catheter, all patients will receive an antibioprophylaxis according to the recommendations of the SFAR (French Society of Anesthesia \& Intensive Care Medecine) and an injection of 10 mg of IV dexamethasone.
The surgical procedure is a total knee arthroplasty (TKA) performed under general anesthesia (GA) with a laryngeal mask. The only difference between the two groups will be the site and technique of local anesthetic (LA) injection.
The patients will be randomized into two groups:
- LIA group (usual technique): surgical local infiltration
- Quadruple nerve blocks group (experimental technique): femoral, sciatic, obturator and lateral femoral cutaneous nerve blocks
In the operating room, general anesthesia will be induced with intravenous ketamine (0.4 mg/kg) and propofol (3 mg/kg). Anesthesia will be maintained with propofol.
Other medications administered intraoperatively:
- Tranexamic acid (1 g)
- Uradipil (5 mg every 3 minutes) if systolic blood pressure (SBP) > 160 mmHg
- Norepinephrine (10 µg every 3 minutes) or Ephedrine (6 mg every 3 minutes) if SBP < 90 mmHg
- Sufentanil (initial dose of 5 µg, then 5 µg every 5 minutes as needed at the anesthesiologist's discretion)
Postoperative analgesia protocol:
- Multimodal analgesia will be instituted from the end of the surgery by the administration of paracetamol (1 g) and ketoprofen (100 mg).
- In post-anesthesia care unit (PACU): oxycodone titration if VRS (pain score) >3 according to the centre's usual care.
- In ward: systematic per os analgesia with paracetamol (1 g, 4 times a day) and ibuprofen (400 mg, 3 times a day), oxycodone (10 mg, lockout interval: 4 h) if VRS (pain score) >3 and cryotherapy.
- Conditions
- Total Knee Arthroplasty
- Being tested
- Surgical local infiltration, Obturator nerve block, Femoral nerve block, Sciatic nerve block, Lateral femoral cutaneous nerve block
- Keywords
- Knee arthroplasty, Local Infiltration Analgesia, Regional anesthesia, Ropivacaine, Postoperative analgesia, Pain management, Opioids
- Medical subject headings
- Agnosia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Surgical local infiltrationProcedure or surgery
Injection of 150 mL of ropivacaine 0.2% into periarticular tissues according to a standardized sequence, including the posterior capsule, collateral ligaments, quadriceps, patellar tendon, capsule and subcutaneous tissue before wound closure
Obturator nerve blockProcedure or surgery
Injection of 20 mL of 0.1% ropivacaine between the adductor magnus and adductor brevis muscles and between the adductor brevis and pectineus muscles
Femoral nerve blockProcedure or surgery
Injection of 15 mL of 0.1% ropivacaine under the fascia iliaca, with the patient in supine position
Sciatic nerve blockProcedure or surgery
Injection of 20 mL of 0.1% ropivacaine in the subgluteal space via a lateral approach, with the patient in prone position
Lateral femoral cutaneous nerve blockProcedure or surgery
Injection of 5 mL of 0.1% ropivacaine lateral to the sartorius muscle
| Study group | Role | What they receive |
|---|---|---|
| LIA group | Active comparator | Local infiltration analgesia Receives: Procedure: Surgical local infiltration |
| Quadruple nerve blocks group | Experimental | Femoral, sciatic, obturator and lateral femoral cutaneous nerve blocks Receives: Procedure: Obturator nerve block; Procedure: Femoral nerve block; Procedure: Sciatic nerve block; Procedure: Lateral femoral cutaneous nerve block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Total opioid consumption within 24 hours
Total cumulative opioid consumption during the first 24 hours, expressed in oral morphine equivalents (OME, mg), including intraoperative and postoperative opioid administration.
Measured: From start of surgery (t0) to 24 hours postoperatively
Secondary outcomes (15)
Intraoperative anesthetic consumption
Total intraoperative consumption of propofol (mg)
Measured: During surgery
Intraoperative opioid consumption
Total intraoperative consumption of sufentanil (µg)
Measured: During surgery
Intraoperative hypertension events
Occurrence of intraoperative hypertension episodes defined as systolic blood pressure >160 mmHg
Measured: During surgery
Intraoperative hypotension events
Occurrence of intraoperative hypotension episodes defined as systolic blood pressure <90 mmHg
Measured: During surgery
Postoperative pain intensity
Pain intensity at rest assessed using a verbal rating scale (VRS, 0-10) ranging from 0 to 10 (0=no pain, 10=worst possible pain), recorded every 6 hours during the first 48 postoperative hours
Measured: Up to 48 hours postoperatively
Total opioid consumption within 48 hours
Total cumulative opioid consumption during the first 48 hours, expressed in oral morphine equivalents (OME, mg), including intraoperative and postoperative opioid administration.
Measured: From start of surgery (t0) to 48 hours postoperatively
Opioid-related adverse effects
Incidence of nausea and vomiting, somnolence, constipation, acute urinary retention, pruritus, and disorientation.
Measured: Up to 48 hours postoperatively
Quadricep motor function
Quadriceps muscle strength assessed on a 3-point scale: 0 = paralysis; 1 = paresis; 2 = normal contraction
Measured: Postoperative days 0, 1, and 2
Foot elevator muscle motor function
Ankle dorsiflexor muscle strength assessed on a 3-point scale: 0 = paralysis; 1 = paresis; 2 = normal contraction
Measured: Postoperative days 0, 1, and 2
Ability to stand and walk
4-point scale: 0 = unable to get up; 1 = able to get up but unable to walk; 2 = able to walk <50 m; 3 = able to walk ≥50 m
Measured: Postoperative days 0, 1, and 2
Mobility and balance
Timed Up and Go (TUG) test, measured in seconds
Measured: Postoperative days 0, 1, and 2
Functional Independence
Functional Independence Measure (FIM), with total scores ranging from 18 to 126, where higher scores indicating greater independence
Measured: Postoperative days 0, 1, and 2
Postoperative falls
Occurrence of any fall defined as an unintentional event resulting in the patient coming to rest on the ground or a lower level
Measured: Postoperative days 0, 1, and 2
Hospital readmission within 30 days
Any hospital readmission within 30 days after surgery, regardless of cause
Measured: 30 days postoperatively
Functional outcome at 60 days
Short-form WOMAC index focused on physical function), with total scores ranging from 0 to 28, where higher scores indicating greater functional impairment
Measured: 60 days postoperatively
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Mar 2026
- Study start2 Sep 2026
- Primary completion3 Mar 2028 (estimated)
- Study completion2 May 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Total Knee ArthroplastyStudies of the same condition, open and under way.
- 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
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Care provider, Outcomes assessor
- Enrolment
- 80 participants (estimated)
Sponsor and investigators
- Lead sponsor
- CMC Ambroise Paré
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07477730
- Sponsor's protocol ID
- 2025/02
- Acronym
- LIAQ
- Status last verified
- Sep 2026
- First submitted
- 13 Mar 2026
- Last updated
- 14 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Local Infiltration Analgesia Versus Quadruple Nerve Blocks in Total Knee Arthroplasty: a Randomized Controlled Trial.
- ClinicalTrials.gov ID
- NCT07477730
- Acronym / sponsor ID
- LIAQ / 2025/02
- Conditions
- Total Knee Arthroplasty
- Keywords
- Knee arthroplasty, Local Infiltration Analgesia, Regional anesthesia, Ropivacaine, Postoperative analgesia, Pain management, Opioids
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 80 participants (estimated)
- Lead sponsor
- CMC Ambroise ParéUniversity, hospital or other
- Study start
- 2 Sep 2026 (actual)
- Primary completion
- 3 Mar 2028 (estimated)
- Study completion
- 2 May 2028 (estimated)
- First posted
- 17 Mar 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.
Total knee arthroplasty (TKA) is one of the most common orthopedic surgical procedures and is associated with severe pain in the immediate postoperative period, thus limiting early recovery.
Optimal postoperative pain management after TKA is not fully defined. While multimodal analgesia is standard, the choice of associated regional anesthesia techniques is debated.
Local infiltration analgesia (LIA) is widely used and provides effective pain relief without impairing early mobilization.
Peripheral nerve blocks have been discussed due to the risk of motor blockade, but low-concentration local anesthetics, such as 0.1% ropivacaine, allow sensory blockade while preserving motor function. Preliminary studies suggest that this concentration is effective and safe.
The main objective of this monocenter, prospective, randomized, open-label, controlled trial is to compare the analgesic efficacy of a quadruple nerve blocks (femoral, sciatic, obturator, and lateral femoral cutaneous nerves) using 0.1% ropivacaine versus standard LIA in patients undergoing TKA.
Detailed description
In the pre-anaesthesia room, after the implementation of classical monitoring with an oxygen mask and a peripheral venous catheter, all patients will receive an antibioprophylaxis according to the recommendations of the SFAR (French Society of Anesthesia \& Intensive Care Medecine) and an injection of 10 mg of IV dexamethasone.
The surgical procedure is a total knee arthroplasty (TKA) performed under general anesthesia (GA) with a laryngeal mask. The only difference between the two groups will be the site and technique of local anesthetic (LA) injection.
The patients will be randomized into two groups:
- LIA group (usual technique): surgical local infiltration
- Quadruple nerve blocks group (experimental technique): femoral, sciatic, obturator and lateral femoral cutaneous nerve blocks
In the operating room, general anesthesia will be induced with intravenous ketamine (0.4 mg/kg) and propofol (3 mg/kg). Anesthesia will be maintained with propofol.
Other medications administered intraoperatively:
- Tranexamic acid (1 g)
- Uradipil (5 mg every 3 minutes) if systolic blood pressure (SBP) > 160 mmHg
- Norepinephrine (10 µg every 3 minutes) or Ephedrine (6 mg every 3 minutes) if SBP < 90 mmHg
- Sufentanil (initial dose of 5 µg, then 5 µg every 5 minutes as needed at the anesthesiologist's discretion)
Postoperative analgesia protocol:
- Multimodal analgesia will be instituted from the end of the surgery by the administration of paracetamol (1 g) and ketoprofen (100 mg).
- In post-anesthesia care unit (PACU): oxycodone titration if VRS (pain score) >3 according to the centre's usual care.
- In ward: systematic per os analgesia with paracetamol (1 g, 4 times a day) and ibuprofen (400 mg, 3 times a day), oxycodone (10 mg, lockout interval: 4 h) if VRS (pain score) >3 and cryotherapy.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (care provider, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| LIA group | Active comparator | Procedure: Surgical local infiltrationLocal infiltration analgesia |
| Quadruple nerve blocks group | Experimental | Procedure: Obturator nerve block, Procedure: Femoral nerve block, Procedure: Sciatic nerve block, Procedure: Lateral femoral cutaneous nerve blockFemoral, sciatic, obturator and lateral femoral cutaneous nerve blocks |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Patients undergoing primary total knee arthroplasty under general anesthesia (laryngeal mask airway)
- Fully autonomous at home
- Planned discharge to home
- Consent for participation
- Affiliation to a social security system
Key exclusion criteria (7 listed)
- Preoperative opioid use
- Chronic pain syndrome
- Valgus contraindicating sciatic nerve block
- Contraindication to any drugs used in the protocol
- Contraindication to laryngeal mask airway
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 |
|---|---|---|
| Surgical local infiltrationInjection of 150 mL of ropivacaine 0.2% into periarticular tissues according to a standardized sequence, including the posterior capsule, collateral ligaments, quadriceps, patellar tendon, capsule and subcutaneous tissue before wound closure | Procedure or surgery | LIA group |
| Obturator nerve blockInjection of 20 mL of 0.1% ropivacaine between the adductor magnus and adductor brevis muscles and between the adductor brevis and pectineus muscles | Procedure or surgery | Quadruple nerve blocks group |
| Femoral nerve blockInjection of 15 mL of 0.1% ropivacaine under the fascia iliaca, with the patient in supine position | Procedure or surgery | Quadruple nerve blocks group |
| Sciatic nerve blockInjection of 20 mL of 0.1% ropivacaine in the subgluteal space via a lateral approach, with the patient in prone position | Procedure or surgery | Quadruple nerve blocks group |
| Lateral femoral cutaneous nerve blockInjection of 5 mL of 0.1% ropivacaine lateral to the sartorius muscle | Procedure or surgery | Quadruple nerve blocks group |
Primary outcome
Total opioid consumption within 24 hours
Time frame: From start of surgery (t0) to 24 hours postoperatively
Total cumulative opioid consumption during the first 24 hours, expressed in oral morphine equivalents (OME, mg), including intraoperative and postoperative opioid administration.
15 secondary outcomes
Intraoperative anesthetic consumption
Time frame: During surgery
Intraoperative opioid consumption
Time frame: During surgery
Intraoperative hypertension events
Time frame: During surgery
Intraoperative hypotension events
Time frame: During surgery
Postoperative pain intensity
Time frame: Up to 48 hours postoperatively
Total opioid consumption within 48 hours
Time frame: From start of surgery (t0) to 48 hours postoperatively
Opioid-related adverse effects
Time frame: Up to 48 hours postoperatively
Quadricep motor function
Time frame: Postoperative days 0, 1, and 2
Foot elevator muscle motor function
Time frame: Postoperative days 0, 1, and 2
Ability to stand and walk
Time frame: Postoperative days 0, 1, and 2
Mobility and balance
Time frame: Postoperative days 0, 1, and 2
Functional Independence
Time frame: Postoperative days 0, 1, and 2
Postoperative falls
Time frame: Postoperative days 0, 1, and 2
Hospital readmission within 30 days
Time frame: 30 days postoperatively
Functional outcome at 60 days
Time frame: 60 days postoperatively
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 14 Sep 2026.
Related trials for Total Knee Arthroplasty
Active, not recruiting
Pivotal Study on the NOVABLOC System for Patients Undergoing Primary Total Knee Arthroplasty
Pain
Not yet recruiting
Opioid Reduction and Enhanced Recovery in Orthopaedic Surgery (OREOS)-Knee
Knee Arthroplasty, Total, Partial Knee Arthroplasty
RecruitingPhase 2/3
Evaluation of PLG0206 in Prevention of Recurrent Infection in Patients Undergoing Debridement, Antibiotics, and Implant Retention (DAIR) for Treatment of a Periprosthetic Joint Infection (PJI) Following Knee Arthroplasty
Prosthetic-joint Infection
Not yet recruitingObservational study
Agreement Between Patient-Reported Pain, Observer-Rated Pain Behavior, and Analgesic Request After Total Knee Arthroplasty
Postoperative Pain After Total Knee Arthroplasty
Enrolling by invitationObservational study
Smartphone Video-Based AI Gait Analysis Reports to Support Remote Follow-up After Total Knee Arthroplasty
Total Knee Arthroplasty
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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Surgical local infiltration, Obturator nerve block and Femoral nerve block in people with Total Knee Arthroplasty, run by CMC Ambroise Paré at 1 site in France.
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 5 inclusion and 7 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: looking for participants now, as of the sponsor's last update on 14 Sep 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 France. 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 Philippe MARTY, MD (05 62 13 29 97 ext. 33, philippemarty@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Total opioid consumption within 24 hours (time frame: From start of surgery (t0) to 24 hours postoperatively). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 14 Sep 2026.