130 patients who underwent total joint replacement of the knee or hip were enrolled in this study to determine the effects that different doses of dexamethasone can have on postoperative pain, nausea and functional and clinical outcomes. Patients were randomized into three separate treatment groups. The control group was administered ondansetron and the intervention groups received 1 or 2 doses of ondansetron and dexamethasone. The evidence of this study suggests that dexamethasone can reduce postoperative pain, nausea, length of hospital stay and required narcotics while increasing ambulation. A second dose of dexamethasone can further improve length of hospital stay, hydrocodone consumption, pain severity and rescue antiemetic medication requirements.