Adductor Canal Localization in Living and Cadaver

The aim of this study is to define the starting and ending points of the adductor canal (AC) in the context of adductor canal block (ACB) applications, through distance measurements related to the anterior superior iliac spine (ASIS) and adductor tubercle. These measurements are performed in two different planes: the first plane is along an imaginary line drawn between the ASIS and the femoral adductor tubercle, while the second plane is formed by the line between the ASIS and the base of the patella.

In these planes, distances were measured between the following points:

The distance between the adductor tubercle and ASIS,

The distance between ASIS and the base of the patella,

The distance between ASIS and the apex of the patella,

The distance between the midpoint of the inguinal fold and the base of the patella.

In patients, ultrasound was used to identify and mark the following anatomical points:

The apex of the iliopectineal fossa,

The first visible point of the vastoadductor membrane (VAM),

The point where the sartorius muscle ends with the intersection of the adductor longus and begins its contact with the edge of the adductor magnus point

The point where the adductor hiatus is located.

Additionally, in patients where visible, the descending genicular artery was also marked.

The position of the femoral artery in relation to the VAM (medial, middle, or lateral) was noted, as well as the location where the femoral artery intersects the adductor magnus and sartorius, and the depth from the skin to the adductor hiatus. Circumferential measurements of the thigh were also taken at these points.

Some of the data obtained was compared with anatomical measurements obtained through cadaveric dissection.

Key Research Questions

Where are the starting and ending points of the adductor canal?

Can the adductor canal be defined along a line drawn between the ASIS and the adductor tubercle?

Is there a definable relationship between the block application site and anatomical landmarks such as the vastoadductor membrane (VAM), the apex of the femoral triangle, and other adjacent structures that facilitate localization?

By validating ultrasound measurements with cadaveric findings, the study aims to provide researchers with a more predictable and reliable method for determining the optimal site for adductor canal block applications

Primary outcomes

• location of the adductor canal [Perioperative/Periprocedural]: Determine the location of the adductor canal on an imaginary line drawn between the anterior superior iliac spine and the adductor tubercle..

Secondary outcomes

• Determining the entry point for adductor canal block [Perioperative/Periprocedural]: Standardization of the entry point for adductor canal block by defining the relationship of the canal to other structures
• Adductor Canal neighborhoods [Perioperative/Periprocedural]: Detection of the canal by imaging the Vasto adductor membrane
• cadaver dissection [Perioperative/Periprocedural]: Determining the compatibility of the data obtained in ultrasonographic imaging with the real anatomical structures after cadaver dissection
• adductor canal [Perioperative/Periprocedural]: measuring adductor canal length

Sex: All, ages: 18 Years to 65 Years

Inclusion Criteria:

ASA 1-2-3 patients

BMI <35

Ages 18-65

Those willing to participate in the study

Exclusion Criteria:

Those unwilling to participate in the study

Pregnant women

BMI >35

ASA 4-5-6 patients

• Müge Çakırca, Associate Professor, Study director, Ankara Etlik City Hospital