Seven randomized controlled trials were included in this meta-analysis comparing the analgesic efficacy of supplemental sciatic nerve block to supplemental local infiltration analgesia when used alongside femoral nerve block in total knee arthroplasty. Results demonstrated lower visual analog scale (VAS) pain at rest at 12 hours with SNB versus LIA consistently across analyses, as well as at 48 hours in particular subgroups; when single-shot femoral nerve block was used or when spinal anaesthesia was used. Otherwise, no significant differences between SNB and LIA groups were noted in morphine consumption, length of stay, incidence of postoperative nausea and vomiting, incidence of falls, or knee range of motion.