120 patients undergoing total knee arthroplasty were randomized to receive either oral dexamethasone (DEX-8 or DEX-16) or a placebo following surgery. The primary outcome of this trial was to assess pain scores using the Visual Analog Scale (VAS) at rest and during motion for 2 weeks. The secondary outcomes of interest were incidence of postoperative nausea and vomiting (PONV), fasting blood sugar (FBS), serum C-reactive protein (CRP) level, opioid consumption, range of motion (ROM), and function assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Both DEX-16 and DEX-8 groups had lower VAS scores between 18 hours and 6 days follow-up at rest and with movement when compared to the placebo group. Pain scores were similar between the DEX-16 and DEX-8 groups.