16 randomized controlled trials were included in this meta-analysis comparing the postoperative analgesia efficacy of local infiltration analgesia in total knee arthroplasty compared to regional blockade (RB) (epidural analgesia [EA] and peripheral nerve block [PNB]). Results demonstrated significantly lower pain at rest scores with LIA versus RB. However, subgroup analysis suggested lower pain scores to be true for LIA versus EA, but not LIA versus PNB. Earlier functional recovery was noted with LIA versus RB. No significant differences in side effects or complications were noted in pooled analyses.