Adductor canal and IPACK (infiltration between the popliteal artery and the capsule of the knee) blocks versus genicular nerves block for total knee arthroplasty: A randomized clinical trial

2025-523071-34-00 Protocol ADIPGEN Therapeutic use (Phase IV) Authorised, recruitment pending

Status Authorised, recruitment pending · 1 EU/EEA countries · 1 sites · Protocol ADIPGEN

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Authorised, recruitment pending
Participants planned 64
Countries 1
Sites 1

Knee Osteoarthritis

Compare the analgesic efficacy between Geniculate Nerve Blocks versus the combination of IPACK (infiltration between the popliteal artery and the capsule of the knee) and Adductor Canal Blocks in patients undergoing primary total knee replacement (TKR). This will be evaluated during the first physiotherapy session at 2…

Key facts

Sponsor
Fundacio De Recerca Clinic Barcelona-Institut D’Investigacions Biomediques August Pi I Sunyer
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Musculoskeletal Diseases [C05]
Decision date (initial)
2026-02-06
Transition trial
No
Low-intervention
Yes
Rare-disease indication
No
Vulnerable population
No

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Therapy, Efficacy

Compare the analgesic efficacy between Geniculate Nerve Blocks versus the combination of IPACK (infiltration between the popliteal artery and the capsule of the knee) and Adductor Canal Blocks in patients undergoing primary total knee replacement (TKR). This will be evaluated during the first physiotherapy session at 24 hours postoperatively, using the Numerical Rating Scale (NRS) for pain assessment.

Secondary objectives 4

  1. Compare the cumulative consumption of rescue opioids at 24 and 48 hours between the aforementioned interventions.
  2. Assess and compare the analgesic efficacy between the aforementioned blocks in the postoperative period. This includes at the moment of spinal block reversal, and at 0, 12, and 48 hours using the NRS at rest.
  3. Evaluate the range of joint mobility during the initial assessment by physiotherapy.
  4. Measure the quality of recovery after surgery.

Conditions and MedDRA coding

Knee Osteoarthritis

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 3

  1. All patients undergoing primary total knee arthroplasty who provide consent to participate in the study and whose attending surgeon also agrees to the study.
  2. ASA physical status classification I-III.
  3. BMI 18-40 kg/m2.

Exclusion criteria 10

  1. Patients who refuse to undergo the block procedure, who refuse to give their consent, or who are unable to cooperate with protocol compliance.
  2. Patients requiring general anesthesia.
  3. Age younger than 18 years or older than 90 years.
  4. Patients undergoing bilateral arthroplasty, revision arthroplasties, or prosthetic replacements.
  5. Contraindication for peripheral nerve block (local infection, neurological deficit, complex regional pain syndrome, previous trauma, or surgery on the ipsilateral knee).
  6. Systemic infection.
  7. Consumption of opioids during the last 4 weeks at doses greater than 30 mg of oral morphine or equivalent.
  8. Patients with a hemorrhagic diathesis or coagulopathy (diagnosed by medical history or laboratory tests).
  9. Patients with allergies to any medication that is part of the protocol (e.g., allergy to local anesthetics).
  10. Patients in whom the total dose of local anesthetic exceeds the calculated toxic dose based on their ideal body weight.

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. The Numerical Rating Scale (NRS) for pain.

Secondary endpoints 4

  1. Opioid consumption measured in morphine equivalents in milligrams.
  2. Range mobility measured by active and passive Range of Motion (ROM) Assessment.
  3. Quality of recovery 15 (QoR 15 questionnare).
  4. Evaluate NRS at 0, 12 and 48h postoperatively.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 2

Ropivacaína B. Braun 2 mg/ml solución inyectable y para perfusión EFG

PRD2147352 · Product

Active substance
Ropivacaine Hydrochloride
Pharmaceutical form
SOLUTION FOR INJECTION/INFUSION
Route of administration
PERINEURAL USE
Max daily dose
70 mg milligram(s)
Max total dose
70 mg milligram(s)
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
N01BB09 — ROPIVACAINE
Marketing authorisation
76678
MA holder
B.BRAUN MELSUNGEN AG
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Adrenalina B. Braun 1 mg/ml Solución Inyectable

PRD11876805 · Product

Active substance
Epinephrine
Pharmaceutical form
SOLUTION FOR INJECTION
Route of administration
PERINEURAL USE
Max daily dose
350 µg microgram(s)
Max total dose
350 µg microgram(s)
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
C01CA — ADRENERGIC AND DOPAMINERGIC AGENTS
Marketing authorisation
68552
MA holder
B.BRAUN MEDICAL, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Fundacio De Recerca Clinic Barcelona-Institut D’Investigacions Biomediques August Pi I Sunyer

Sponsor organisation
Fundacio De Recerca Clinic Barcelona-Institut D’Investigacions Biomediques August Pi I Sunyer
Address
Calle Rosellon 149-153
City
Barcelona
Postcode
08036
Country
Spain

Scientific contact point

Organisation
Fundacio De Recerca Clinic Barcelona-Institut D’Investigacions Biomediques August Pi I Sunyer
Contact name
Clinical Trials Unit

Public contact point

Organisation
Fundacio De Recerca Clinic Barcelona-Institut D’Investigacions Biomediques August Pi I Sunyer
Contact name
Clinical Trials Unit

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Spain Authorised, recruitment pending 64 1
Rest of world 0

Investigational sites

Spain

1 site · Authorised, recruitment pending
Hospital Clinic De Barcelona
Anesthesiology, Calle Villarroel 170, 08036, Barcelona

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 12 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) Protocol ADIPGEN EN 2.0
Protocol (for publication) Protocol ADIPGEN v2 1 EN 2.1
Protocol (for publication) Protocol ADIPGEN v2 1 EN control de cambios 2.1
Recruitment arrangements (for publication) Recruitment arrengements 1
Subject information and informed consent form (for publication) Apendice 1 Informacion esencial para el paciente. 1
Subject information and informed consent form (for publication) HIP y CI ADIPGEN v1 2 1.2
Subject information and informed consent form (for publication) HIP y CI ADIPGEN v1 3 1.3
Subject information and informed consent form (for publication) HIP y CI ADIPGEN v1 3 control de cambios 1.3
Summary of Product Characteristics (SmPC) (for publication) adrenalina ficha tecnica 1
Summary of Product Characteristics (SmPC) (for publication) Ropivacaina Ficha tecnica 1
Synopsis of the protocol (for publication) ADIPGEN sinopsis ENG 1
Synopsis of the protocol (for publication) Sinopsis del protocolo ADIPGEN 1

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2025-10-09 Spain Acceptable
2026-02-02
2026-02-06