One hundred and sixty patients with knee osteoarthritis (OA) scheduled for a total knee arthroplasty were randomized to receive a transdermal buprenorphine patch or oral celecoxib for the relief of pain post-operation. Outcomes of interest included pain at rest and during activity on a Visual Analog Scale (VAS), range of motion, Lysholm Knee Scores, and the incidence of adverse events. Outcomes were assessed up to 14 days post-operation. VAS pain score at rest were significantly in favour of the patch group up to 48 hours post-operation, whilst VAS pain scores during activity were significantly in favour of the patch group up to 3 days post-operation(p<0.05 for all). Range of motion at 1, 2, and 3 days post-operation (p=0.001, p=0.016, p=0.037; respectively), as well as Lysholm Knee Scores at 3 days post-operation (p=0.01), were statistically significantly in favour of the patch group. No statistically significant differences in the incidence of adverse events were observed between the two treatment groups (p>0.5 for all).