All patients met the following inclusion and exclusion criteria: no history of anesthetic allergy or nerve damage no infectious diseases normal coagulation function and no history of severe hepatorenal insufficiency, psychiatric disorders, or drug dependence. The age range of these patients was 50–80 years, their bodyweight ranged from 50 to 90 kg, and each patient had an American Society of Anesthesiologists (ASA) physical status of I–III. From January 2018 to August 2018, 60 male and female patients who were scheduled to undergo elective unilateral knee arthroplasty were enrolled in this study. All patients provided written informed consent before undergoing surgery. The ethics committee of the researchers’ hospital approved the present study (Medical Ethics Approval Number: QYFYWZLL 25588). 9 In the present study, we aimed to evaluate the impact of ultrasound-guided IPACK combined with adductor canal block on limb motor function and early functional rehabilitation of the knee joint in patients undergoing TKA. Its combined use with adductor canal block has a good analgesic effect and little impact on the muscle strength of the affected limbs post-operation, and patients treated with this method can participate in early rehabilitation exercise, have shorter hospital stays, and report improved satisfaction. Infiltration between the Popliteal Artery and the Capsule of the Knee (IPACK) is a new method that has been proposed in recent years as a potential alternative to the sciatic nerve block. However, limited research has been conducted to date on the early recovery of motor function after an operation. Following the introduction of ERAS and the improvement of the analgesic effect, a new goal is to achieve self-controlled joint movement as early as possible after an operation. 8 Analgesia after TKA has been the focus of several studies in recent years, and it has been found that ultrasound-guided nerve block analgesia can significantly improve patient satisfaction. In ERAS, the goals of pain management are to minimize postoperative pain, promote early recovery and rehabilitation, and improve the patient’s functional outcomes. The ERAS model was first proposed by Professor Henrik Kehlet at the Copenhagen University in Denmark in 1997, and it was introduced to China by academician Jieshou Li in 2006. 6, 7 However, this method cannot prevent posterior knee pain. 5 Studies have confirmed that an adductor canal block has satisfactory analgesic effects and does not affect quadriceps femoris muscle strength consequently, it could replace the femoral nerve block. Additionally, it can easily cover up peroneal nerve injuries, which occur frequently, as well as other nerve injuries that take place during the operation. ![]() 3, 4 Femoral nerve block combined with sciatic nerve block is used for postoperative analgesia while this achieves a satisfactory analgesic effect, it presents the issues of quadriceps femoris weakness and calf weakness, which limit early autonomic exercise and activity of the joints and increase the risk of falls after surgery. 2 Within the model of Enhanced Recovery After Surgery (ERAS), it is required that a patient’s pain should be fully controlled after the operation to help achieve early limb autonomous movement, speed up the rehabilitation process, shorten hospital stays, and improve patient satisfaction. ![]() Pain is the most difficult factor to control following TKA however, the development of an ultrasound-guided nerve block has helped to reduce postoperative pain to a certain extent. 1 However, despite the effectiveness of this approach, the rehabilitation of limbs after a TKA operation still faces critical challenges. ![]() Total Knee Arthroplasty (TKA) is the best treatment option for patients with end-stage joint disease as it provides the benefits of relieving pain and improving joint function.
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