{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:16:13Z","timestamp":1791483373718,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>To compare the analgesic efficacy and adverse events of proximal versus distal ACB for adults undergoing knee arthroplasty, we searched PubMed, Cochrane, Web of Science, and Embase to identify all eligible randomized controlled trials (RCTs). The study quality of the RCTs was evaluated using the Cochrane risk of bias assessment tool. Heterogeneity among studies was examined by Cochrane <jats:italic>Q<\/jats:italic> test. Our primary outcomes were pain intensity at rest\/during movement and morphine consumption. Statistical analyses were conducted by RevMan Software. Seven eligible studies involving 400 subjects were included in this meta\u2010analysis with 202 participants in the proximal ACB group and 198 participants in the distal ACB group. The results demonstrated that proximal ACB provided significantly better pain relief at rest at 2\u2009h (SMD \u22120.27, 95% CI \u22120.54 to \u22120.01, four trials, 222 participants, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) and 24\u2009h (SMD \u22120.28, 95% CI \u22120.48 to \u22120.08, seven trials, 400 participants, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) following the surgery. We found no evidence of a difference in postoperative pain intensity at other timepoints. Furthermore, we noted no evidence of a difference in cumulative morphine consumption and occurrence of adverse events. Proximal ACB provides better pain relief and comparable adverse effects profile compared with distal ACB. The analgesic benefit offered by proximal ACB, however, did not appear to extend beyond the first 24\u2009h. The overall evidence level was mostly low or very low, which requires more well\u2010organized multicenter randomized trials in the future.<\/jats:p>","DOI":"10.1111\/os.14027","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T10:07:09Z","timestamp":1710929229000},"page":"1019-1033","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Does Proximal Adductor Canal Block Provide Better Analgesic Efficacy than Distal Adductor Canal Block in Patients Undergoing Knee Arthroplasty: A\u00a0Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5556-2586","authenticated-orcid":false,"given":"Qiangqiang","family":"Li","sequence":"first","affiliation":[{"name":"State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital Clinical College of Nanjing University  Nanjing People's Republic of China"},{"name":"Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation  Nanjing People's Republic of China"},{"name":"State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaikai","family":"Zhuang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital Clinical College of Nanjing University  Nanjing People's Republic of China"},{"name":"Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation  Nanjing People's Republic of China"},{"name":"State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongyang","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery Nanjing Drum Tower Hospital Clinical College of Nanjing University  Nanjing People's Republic of China"},{"name":"Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation  Nanjing People's Republic of China"},{"name":"State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive 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