Three hundred and thirty patients undergoing primary unilateral total knee arthroplasty were randomized to receive a continuous adductor canal catheter either via ultrasound-guided anesthetist insertion (Group A, n=152) or via intraoperative surgeon insertion through the knee arthrotomy (Group B, n=160). The primary outcome was pain, measured by visual analog scale (VAS) at rest and during mobilization. Secondary outcomes included range of motion, timed functional tests (Timed Up and Go, 10-meter walk, 30-second chair test), maximum ambulation, time to straight leg raise, ambulation with walker, and length of stay. Outcomes were assessed preoperatively and at 6, 12, and 24 hours postoperatively. Overall, the results of the study revealed no significant differences between the groups on most parameters, though pain at rest at 12 hours was significantly lower in the surgeon group. This study suggests that the novel surgeon-administered technique is a viable, safe, and potentially cost-effective alternative to the ultrasound-guided method.