OBJECTIVES: In response to increasing demand and limited resources, hospitals are exploring more efficient methods to perform TKA. The objective of this study was to examine the clinical and economic outcomes associated with using local infiltration of LB to manage postsurgical pain following TKA. METHODS: This study compared 134 consecutive patients whose postsurgical pain following TKA was managed using local infiltration of LB (study group) to 134 historical patients who received continuous nerve block with elastomeric pumps (control group). Groups were matched on clinical and demographic variables, including age, gender, race, and comorbidities, and sample size was based on estimated effect sizes. Outcomes examined included use of postsurgical opioid and non-opioid analgesics, time to ambulation, distance walked, pain scores, adverse effects, length of stay (LOS), discharge status, and total hospital costs. RESULTS: Significantly more patients in the study group (22%) were able to ambulate on the day of surgery than in the control group (3%) (p<0.05). The study group had more patients discharged in 3 days or less (50%) than the control group (19%) (p<0.05), and had a shorter mean LOS (2.8 ±1.7 days vs. 3.2±1.6 days). Total hospital costs were $366 less in the study group ($8,816/patient) than in the control group ($9,182/patient), which was mainly attributed to differences in the cost of room and board ($1,449 vs. $1,721, p<0.05). After multivariate regression, adjusted cost savings in the study group were $457/patient (p<0.05). No differences were found between in pain scores, opioid analgesic use, adverse events, or 30-day readmissions. CONCLUSIONS: When comparing well-matched patients undergoing TKA, significantly better clinical and economic outcomes were found using local infiltration of LB rather than continuous nerve block with elastomeric pumps to manage postsurgical pain.