Enhanced Recovery After Surgery (ERAS) Total Knee Replacement (TKR) With a Transitional Pain Service

Patients will be randomized to one of two groups: one group will receive a PAI, IPACK and
single-shot adductor canal block; one group will receive PAI, IPACK and continuous adductor
canal block catheter.

Inclusion Criteria:

- Patients with osteoarthritis scheduled for a primary total knee arthroplasty with a
participating surgeon

- Planned use of regional anesthesia

- Ability to follow study protocol

- English speaking (secondary outcomes include questionnaires validated in English only)

- Lives within one hour of the hospital

- Has a smart phone

Exclusion Criteria:

- Hepatic or renal insufficiency

- Younger than 18 years old or older than 65 years ol

- Patients undergoing general anesthesia

- Allergy or intolerance to one of the study medications

- BMI >40

- Diabetes

- American Society of Anesthesiologists (ASA) status III or IV

- Chronic gabapentin/pregabalin use (regular use for longer than 3 months)

- Patients with chronic pain (from a referral to chronic pain service) or a pain
catastrophizing scale (PCS >30)

- Patients with severe valgus deformity or flexion contracture

- Patients unable to follow home catheter instructions and unwilling to go home with an
infusing catheter

- Patients who have no home caregivers in the event that a catheter is to be sent home
with the patient

- Patients with planned stay at rehab facility (to avoid medical device being tampered
with at the rehab facility)

- Non-English speakers (secondary outcomes include questionnaires validated in English
only)