Significant isokinetic deficits found with femoral nerve block use after ACL reconstruction
After ACL reconstruction, pediatric and adolescent patients treated with femoral nerve block for postoperative analgesia experienced significant isokinetic deficits in knee extension and flexion strength compared with patients who did not receive a nerve block, researchers found.
The researchers identified 124 patients 18 years and younger who underwent primary ACL reconstruction between 2000 and 2010. Patients who were skeletally immature underwent a transphyseal ACL reconstruction. All patients participated in a comprehensive rehabilitation program that included isokinetic strength and function testing at 6 months postoperatively.
Overall, the researchers included 62 patients in the femoral nerve block (FNB) group and 62 patients in the control group, with 69% of patients in the FNB group and 66% of patients in the control group undergoing reconstruction with a patellar tendon graft, and 31% in the FNB group and 34% in the control group undergoing hamstring autograft.
According to univariate analysis, patients in the FNB group had a significantly higher deficit at 6 months with respect to fast isokinetic extension strength, as well as fast and slow isokinetic flexion strength. However, the researchers found no difference in slow isokinetic extension strength deficit or deficit for vertical jump, single hop or triple hop between the two groups.
At 6 months, a significantly higher percentage of patients in the control group met functional and isokinetic criteria for return to sports, according to the researchers. – by Casey Tingle
Disclosure: Luo reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.