{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T23:07:30Z","timestamp":1787180850440,"version":"build-2736575974"},"reference-count":34,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is no pain management standard for anterior cruciate ligament reconstruction (ACLR) or one that addresses posterior capsule pain from hamstring autograft collection. IPACK (Infiltration of local anesthetic between the Popliteal Artery and Capsule of the Knee) is a novel peripheral nerve block designed as an analgesic for the posterior capsule. IPACK use has been beneficial in decreasing reported pain and medications needed for adult total knee arthroplasty; thus, it may be helpful for ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>We hypothesized that adding IPACK to the adductor canal block (ACB) would decrease pain levels and opioids provided for adolescents who undergo ACLR with hamstring autografts as compared with local infiltration analgesia (LIA) or ACB only.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective chart review was conducted for 153 adolescent patients, aged 10 to 18 years, who underwent ACLR with hamstring autografts at a single hospital over 17 months. The type of regional block was determined by the surgeon\u2019s preference, and patients received LIA only, ACB only, or IPACK + ACB. They were compared across these groups to identify the efficacy of each analgesic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients across the entire cohort received a mean of 31.6 \u00b1 12.9 morphine milligram equivalents (MME); the MME did not differ significantly based on regional blocks of LIA only, ACB only, and IPACK + ACB (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .234). Pain levels in the postanesthesia care unit (PACU) were not significantly different from the first (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .293), last (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .845), highest (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .816), or lowest (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .235) pain scores. Patients who received both opioids and non-steroidal anti-inflammatory drugs (NSAIDs) received more MME than patients who only received opioids (10.7 \u00b1 7.1 vs 7.8 \u00b1 4) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003) in the PACU but received similar MME overall (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .38). In the PACU, patients who received opioids + NSAIDs had a higher highest pain score than those who received opioids only (7 \u00b1 2.1 vs 5.5 \u00b1 2.4) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Overall, the amount of MME used at this institution was relatively low; however, the use of IPACK + ACB did not decrease opioid usage or pain levels after ACLR as compared with LIA or ACB only for the adolescent population. Use of any regional block was not superior to LIA for MME or reported pain levels. Given that IPACK + ACB did not decrease MME, it is not recommended to add an IPACK block for ACLR in adolescent patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671251331145","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T11:56:56Z","timestamp":1748001416000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of IPACK-Adductor Canal Block Combination on Adolescent Pain Management After Hamstring Autograft Anterior Cruciate Ligament Reconstruction"],"prefix":"10.1177","volume":"13","author":[{"given":"Colleen M.","family":"Sweeney","sequence":"first","affiliation":[{"name":"University of California, San Diego School of Medicine, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Bomar","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5724-5645","authenticated-orcid":false,"given":"Eric W.","family":"Edmonds","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003976"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000378"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06443-9"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4525-7"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/AIA.0b013e31820e4a49"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000002340"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000053"},{"key":"e_1_3_2_9_2","author":"Department of Health and Human Services (DHHS) Centers for Medicare and Medicaid Services (CMS)","year":"2015","unstructured":"Department of Health and Human Services (DHHS) Centers for Medicare and Medicaid Services (CMS). Opioid Morphine Equivalent Conversion Factors; 2015.","journal-title":"Opioid Morphine Equivalent Conversion Factors"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1464"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.01.065"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06256-2"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-2439"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aanat.2019.05.010"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-001487"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2023.05.005"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738120954432"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2021-102631"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2014.07.002"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120985902"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-020-03724-9"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1213\/XAA.0000000000001135"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.01.014"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(01)00294-9"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002570"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.55275\/JPOSNA-2022-579"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211033995"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/os.13263"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-022-03266-3"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13318-019-00552-0"},{"issue":"3","key":"e_1_3_2_31_2","first-page":"233","article-title":"Novel regional techniques for total knee arthroplasty promote reduced hospital length of stay: an analysis of 106 patients","volume":"17","author":"Thobhani S","year":"2017","unstructured":"Thobhani S, Scalercio L, Elliott CE, et al. Novel regional techniques for total knee arthroplasty promote reduced hospital length of stay: an analysis of 106 patients. Ochsner J. 2017;17(3):233-238.","journal-title":"Ochsner J"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000002344"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-022-01712-7"},{"key":"e_1_3_2_34_2","volume-title":"Interagency Guideline on Prescribing Opioids for Pain","author":"Washington State Agency Medical Directors\u2019 Group (AMDG)","year":"2015","unstructured":"Washington State Agency Medical Directors\u2019 Group (AMDG). Interagency Guideline on Prescribing Opioids for Pain. 3rd ed; 2015.","edition":"3"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.01425"}],"container-title":["Orthopaedic Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671251331145","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259671251331145","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671251331145","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:27:14Z","timestamp":1777595234000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259671251331145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/23259671251331145"],"URL":"https:\/\/doi.org\/10.1177\/23259671251331145","relation":{},"ISSN":["2325-9671","2325-9671"],"issn-type":[{"value":"2325-9671","type":"print"},{"value":"2325-9671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"article-number":"23259671251331145"}}