80 patients scheduled for total knee arthroplasty were randomized to postoperative analgesia through periarticular injection (PAI) or patient-controlled analgesia (PCA) with fentanyl. The purpose of this study was to evaluate if the use of PAI alone provided adequate analgesia in comparison to PCA. Pain scores, analgesic consumption, antiemetic consumption, and functional outcomes were evaluated. Pain scores were significantly lower in the PAI group compared to the PCA group from 6 hours postoperatively to 5 days postoperatively, as well as at 14 days postoperatively. No significant difference between groups was observed in the need to additional analgesics, though a significantly lower need for additional antiemetics was observed in the PAI group compared to the PCA group.