17 randomized controlled trials comparing intra-articular injection of local anesthetic versus placebo in patients undergoing TKA were selected for inclusion (1338 participants). The purpose of the study was to determine the safety and efficacy of intra-articular local anesthetic for postoperative analgesia. Pooled analyses demonstrated that a single local anesthetic injection significantly lowered pain scores at 4, 8 , 24, and 48 hours after surgery. Additionally, intra-articular local anaesthetic was associated with significantly lower opioid consumption and greater knee range of motion at 24, 48 and 72 hours after surgery.