OBJECTIVES: Perioperative pain management is an important aspect of recovery from TKA, as severe pain can delay ambulation and hospital discharge. The objective of this study was to determine the impact of local infiltration analgesia using LB when compared to continuous femoral nerve catheter (FNC) following TKA. METHODS: This study enrolled consecutive patients who received a TKA between April 2011 and September 2014 into three study groups, excluding bilateral and revision TKA. Study Group A received adductor canal infiltration with bupivacaine and knee infiltration with LB. Study Group B received adductor canal infiltration with LB and knee infiltration with LB. The control group received a continuous FNC with an OnQ pump and ropivacaine. Numeric pain rating scores (NPRS), distance walked, and length of stay (LOS) were the primary outcomes. RESULTS: A total of 237 participants were enrolled in this study, including 98 in Group A, 34 in Group B, and 105 controls.  On postoperative day (POD) 0, mean NPRS were similar between Group A (1.8±1.7), Group B (2.7±1.8), and the control group (2.3±2.4). Significantly (p<0.05) more patients in Group A (58%) and Group B (44%) walked on POD 0 than in the control group (0%); almost all patients walked on POD1. The mean distance walked was also significantly greater (p<0.05) on POD0 and on POD1 in Group A (33±42 feet; 193±203 feet) and Group B (42±82 feet; 211±144 feet) than in the control group (0 feet; 46.3±73 feet). LOS was significantly (p<0.05) shorter in Group B (2.2±1.7 days), than in the control group (3.2±0.7 days) and Group A (3.0±1.7 days). CONCLUSIONS: Local infiltration analgesia using LB improved ambulation and LOS following TKA when compared to continuous FNC with an OnQ pump and ropivacaine. The one-day decrease of hospitalization suggests an estimated cost savings to an Illinois hospital of $2,158 per patient.