The purpose of this study is to evaluate the efficacy of two methods of administering an adductor canal block (ACB) following total knee arthroplasty (TKA); intraoperative surgeon performed intra-articular adductor canal block (IACB) and anesthesiologist ultrasound guided ADC in the post-anesthesia recovery unit (PACU).

Inclusion Criteria:

• Patients undergoing unilateral primary TKA with underlying diagnosis of osteoarthritis
• ASA I - III
• Spinal anesthesia
• All patients will have cemented total knee utilizing a medial parapatellar approach with posterior stabilized or cruciate retaining implants. A tourniquet will be used in all cases.
• Patients must be between 18 and 80 years of age.
• Active and valid email address for the participant.

Exclusion Criteria:

• Allergy to anesthetics or study analgesic medications.
• Contraindication to regional anesthesia
• Non-english speaking
• ASA IV or greater
• Renal insufficiency with Cr > 2.0 or hepatic failure
• General or epidural anesthesia
• Sensory/motor disorder involving the operative limb
• Patients who consume preoperative opioids for pain control.
• Pregnant women
• Mentally disabled patients and patients with psychiatric disorders that would prevent them from properly understanding and evaluating an informed consent process.
• Prisoners