Is your goal to please the ortho docs or the patients? If you were a patient which would you have for yourself? Would you really go with the adductor to get in that extra day of PT on POD 0? Does anyone really buy that rehab on POD 0 is better than POD 1? Not me...
Also about the US technique, maybe its not that the imager is failing to see the saphenous nerve due to poor US skill, maybe its that the other imager is easily convinced that a random piece of hyperechoic tissue sitting in the area that the book says it should be is the saphenous nerve and surrounds it with local... then drinks the placebo effect cool aid (surgeon is injecting local, antinflammatories, and narcotic in the knee anyways plus general, plus some femoral spread, lots of reasons a poorly done AC block will have decent results)
Just another perspective. I do believe it is a useful block, the more I do the more I believe. But I dont believe it to make any sense as it is inferior to FNB and we are only doing it to please surgeons at the possible detriment to patients.