• Huan Min, Yulong Ouyang, and Gang Chen.
• Department of Orthopedics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, 92 Aiguo Road, Nanchang, 330006, Jiangxi, China.
• Knee Surg Sports Traumatol Arthrosc. 2020 Aug 1; 28 (8): 2675-2686.

PurposeModerate-to-severe postoperative pain remains a challenge for both patients and surgeons after anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to systematically review the current evidence in the literature to compare adductor canal block (ACB) with femoral nerve block (FNB) in the treatment of ACLR.MethodsA comprehensive search of the published literature in PubMed, Scopus, EMBASE, and Cochrane Library databases was performed. Only English randomized clinical trials (RCTs) were included in this study. The primary outcome was pain score. Secondary outcome measures included opioid consumption, postoperative adverse events, patient satisfaction, and quadriceps strength.ResultsEight RCTs with a total of 587 patients were included. No statistically significant difference was observed between the ACB and FNB groups in pain scores at 6 h, 12 h, 24 h, or 48 h; cumulative opioid consumption at 24 h or 48 h; patient satisfaction at 24 or 48 h; and postoperative adverse event. However, ACB showed superior quadriceps strength in the early postoperative period.ConclusionsBoth treatments provided similar overall pain relief after ACLR. The potential benefits of quadriceps preservation with ACB are worthy of future study. Therefore, ACB is recommended as an attractive alternative to FNB as the peripheral nerve block of choice for ACLR.Level Of EvidenceMeta-analysis of Level 1 was performed in this study.

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