Arthroscopic anterior cruciate ligament reconstruction with adductor canal block

Introduction. Arthroscopic anterior cruciate ligament (ACL) reconstruction with a BTB autograft is associated with the development of anterior knee pain in the area of the donor site. The Adductor Canal Block provides interruption of afferent pain impulses from the donor site which preserves the possibility of early quadriceps muscle activation. The study aimed to determine the effect of the Adductor Canal Block on the development of anterior knee pain and neuromuscular control recovery in ACL surgery with BTB autograft. Material and methods. 104 patients with isolated ACL tears were operated on in the period from 2022 to 2024 using the BTB autograft. The control group consisted of 52 patients (BTB) who underwent ACL reconstruction under spinal anesthesia. Adductor Canal Block supplemented Spinal anesthesia in 52 patients of the leading group (BTBb). The results are based on the severity of pain syndrome using the VAS scale on days 1 and 2 after surgery and the restoration of knee joint function based on plyometric tests at 6, 12, and 24 weeks. Results. On days 1 and 2 after surgery, the intensity of pain syndrome according to the VAS scale in the BTBb group (4.19±0.68 points and 2.56±0.89 points, respectively; p <0.0001) was significantly lower than in the control group (8.23±0.7 and 6.46±0.9 points, respectively; p=0.001). By the end of 6 and 12 weeks, the Single Squat test and Y-balance test values in the BTBb group significantly exceeded similar values in the control group. By the end of week 24, the number of patients who exceeded the 90% threshold in performing a vertical jump on one leg compared to the healthy side was significantly higher in the BTBb group (88.9%) than in the BTB – group (42.3%; p <0.0001). Forward jump on one leg was successfully performed by all patients in the BTBb group (100.0%) and more than half of the BTB group (53.8%; p <0.0001). Lateral jumps on one leg were also performed significantly more often by patients in the BTBb group (70.4%) and less than half of the BTB group (42.3%; p = 0.04). Conclusion. Adductor Canal Block, as an adjunct to spinal anesthesia in arthroscopic ACL reconstruction, significantly reduces the intensity of anterior knee pain. At the same time, the preservation of efferent impulses provides the possibility of early activation of the thigh muscles.