Ten studies were included in this meta-analysis comparing varying routes of administration of ketamine to placebo in patients undergoing total joint arthroplasty (TJA). The primary outcome of interest was pain intensity. Secondary outcomes of interest included cumulative morphine consumption and the incidence of adverse events. Results of the meta-analysis found significantly lower early post-operative pain intensity, cumulative morphine consumption (0-24hr; 0-48hr) and incidence of gastrointestinal events with intravenous ketamine vs. placebo. Late post-operative pain intensity and cumulative morphine consumption (0-48hr) were significantly lower in the intraarticular ketamine group vs. placebo. Data on the efficacy and safety of epidural ketamine in TJA was limited.