One hundred fourteen patients undergoing unilateral total knee arthroplasty were randomized to receive contralateral electroacupuncture (n=38), ipsilateral electroacupuncture (n=38), or sham electroacupuncture (n=38). The primary outcomes of interest were visual analog scale (VAS) pain scores and the additional opioid dose delivered by a patient-controlled analgesia (PCA) pump. Secondary outcomes included Hospital for Special Surgery (HSS) knee scores, active/passive range of motion (AROM/PROM), swelling around the knee joint, and Hamilton anxiety (HAMA) scores. Outcomes were assessed at multiple time points up to 10 days postoperatively. Overall, the results of the study revealed that both contralateral and ipsilateral electroacupuncture significantly reduced postoperative pain and opioid use compared to sham, with no difference between the two active treatments. These findings suggest that either electroacupuncture approach is effective in enhancing short-term postoperative recovery following TKA.