Adductor canal: Intermuscular compartment that begins proximally at apex of femoral triangle and ends distally at adductor hiatus of adductor magnus muscle
SN: Distal and largest cutaneous branch of femoral nerve
SN traverses in close proximity to vessels along its path to distal foot
Alongside femoral artery (FA) above knee
Alongside descending genicular artery and saphenous branch at knee
Alongside great saphenous vein in lower leg and ankle
Adductor canal borders
Anteromedially: Vastoadductor membrane (deep to sartorius muscle)
Laterally: Vastus medialis muscle
Posteromedially: Adductor magnus or adductor longus muscles (depending on how proximal or distal within canal)
Adductor canal contents
FA
Femoral vein (FV)
SN
Nerve to vastus medialis muscle is located in separate myofascial tunnel ventral to AC
SN most often found lateral to FA at proximal portion of canal
Distally, it is found medially to FA
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things To Do
Things To Avoid
OUTCOMES
Problems
Complications
Selected References
Ambrosoli AL et al: Postoperative analgesia and early functional recovery after day-case anterior cruciate ligament reconstruction. a randomized trial on local anesthetic delivery methods for continuous infusion adductor canal block. Minerva Anestesiol. 85(9): 962-70, 2019
Batistaki C et al: Ultrasound-guided saphenous nerve block for saphenous neuralgia after knee surgery: two case reports and review of literature. Indian J Orthop. 53(1):208-12, 2019
Elkassabany NM et al: A prospective randomized open-label study of single injection versus continuous adductor canal block for postoperative analgesia after total knee arthroplasty. Bone Joint J. 101-B(3):340-7, 2019
Kastelik J et al: Local infiltration anaesthesia versus sciatic nerve and adductor canal block for fast-track knee arthroplasty: a randomised controlled clinical trial. Eur J Anaesthesiol. 36(4):255-63, 2019
Klement MR et al: Continuous adductor canal blockade facilitates increased home discharge and decreased opioid consumption after total knee arthroplasty. Knee. ePub, 2019
Kim DH et al: Addition of infiltration between the popliteal artery and the capsule of the posterior knee and adductor canal block to periarticular injection enhances postoperative pain control in total knee arthroplasty: a randomized controlled trial. Anesth Analg. 129(2):526-35, 2018
Koniuch KL et al: Case report of a massive thigh hematoma after adductor canal block in a morbidly obese woman anticoagulated with apixaban. Case Rep Anesthesiol. 2018:7653202, 2018
Nair A et al: Ultrasound-guided adductor canal block: a cadaver study investigating the effect of a thigh tourniquet. Br J Anaesth. 121(4):890-8, 2018
Runner RP et al: Quadriceps strength deficits after a femoral nerve block versus adductor canal block for anterior cruciate ligament reconstruction: a prospective, single-blinded, randomized trial. Orthop J Sports Med. 6(9):2325967118797990, 2018
Tao Y et al: Median effective volume of ropivacaine 0.5% for ultrasound-guided adductor canal block. J Int Med Res. 46(10):4207-13, 2018
Bendtsen TF et al: The optimal analgesic block for total knee arthroplasty. Reg Anesth Pain Med. 41(6):711-9, 2016
Davis JJ et al: Adductor canal block: more than just the saphenous nerve? Reg Anesth Pain Med. 34(6):618-9, 2009
Tubbs RS et al: Anatomy and potential clinical significance of the vastoadductor membrane. Surg Radiol Anat. 29(7):569-73, 2007
Gray H: Anatomy: Descriptive and Surgical. 17th ed. Philadelphia: Lea and Febiger, 1908
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Abbreviations
Adductor canal nerve block (ACNB)
Synonyms
Subsartorial canal
Hunter canal
Definitions
Adductor canal: Intermuscular compartment that begins proximally at apex of femoral triangle and ends distally at adductor hiatus of adductor magnus muscle
SN: Distal and largest cutaneous branch of femoral nerve
SN traverses in close proximity to vessels along its path to distal foot
Alongside femoral artery (FA) above knee
Alongside descending genicular artery and saphenous branch at knee
Alongside great saphenous vein in lower leg and ankle
Adductor canal borders
Anteromedially: Vastoadductor membrane (deep to sartorius muscle)
Laterally: Vastus medialis muscle
Posteromedially: Adductor magnus or adductor longus muscles (depending on how proximal or distal within canal)
Adductor canal contents
FA
Femoral vein (FV)
SN
Nerve to vastus medialis muscle is located in separate myofascial tunnel ventral to AC
SN most often found lateral to FA at proximal portion of canal
Distally, it is found medially to FA
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things To Do
Things To Avoid
OUTCOMES
Problems
Complications
Selected References
Ambrosoli AL et al: Postoperative analgesia and early functional recovery after day-case anterior cruciate ligament reconstruction. a randomized trial on local anesthetic delivery methods for continuous infusion adductor canal block. Minerva Anestesiol. 85(9): 962-70, 2019
Batistaki C et al: Ultrasound-guided saphenous nerve block for saphenous neuralgia after knee surgery: two case reports and review of literature. Indian J Orthop. 53(1):208-12, 2019
Elkassabany NM et al: A prospective randomized open-label study of single injection versus continuous adductor canal block for postoperative analgesia after total knee arthroplasty. Bone Joint J. 101-B(3):340-7, 2019
Kastelik J et al: Local infiltration anaesthesia versus sciatic nerve and adductor canal block for fast-track knee arthroplasty: a randomised controlled clinical trial. Eur J Anaesthesiol. 36(4):255-63, 2019
Klement MR et al: Continuous adductor canal blockade facilitates increased home discharge and decreased opioid consumption after total knee arthroplasty. Knee. ePub, 2019
Kim DH et al: Addition of infiltration between the popliteal artery and the capsule of the posterior knee and adductor canal block to periarticular injection enhances postoperative pain control in total knee arthroplasty: a randomized controlled trial. Anesth Analg. 129(2):526-35, 2018
Koniuch KL et al: Case report of a massive thigh hematoma after adductor canal block in a morbidly obese woman anticoagulated with apixaban. Case Rep Anesthesiol. 2018:7653202, 2018
Nair A et al: Ultrasound-guided adductor canal block: a cadaver study investigating the effect of a thigh tourniquet. Br J Anaesth. 121(4):890-8, 2018
Runner RP et al: Quadriceps strength deficits after a femoral nerve block versus adductor canal block for anterior cruciate ligament reconstruction: a prospective, single-blinded, randomized trial. Orthop J Sports Med. 6(9):2325967118797990, 2018
Tao Y et al: Median effective volume of ropivacaine 0.5% for ultrasound-guided adductor canal block. J Int Med Res. 46(10):4207-13, 2018
Bendtsen TF et al: The optimal analgesic block for total knee arthroplasty. Reg Anesth Pain Med. 41(6):711-9, 2016
Davis JJ et al: Adductor canal block: more than just the saphenous nerve? Reg Anesth Pain Med. 34(6):618-9, 2009
Tubbs RS et al: Anatomy and potential clinical significance of the vastoadductor membrane. Surg Radiol Anat. 29(7):569-73, 2007
Gray H: Anatomy: Descriptive and Surgical. 17th ed. Philadelphia: Lea and Febiger, 1908
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