50 patients undergoing primary total knee arthroplasty for end-stage knee osteoarthritis were randomized to receive either an ultrasound-guided peripheral nerve block (PNB) with ropivacaine and dexmedetomidine (n=25) or local periarticular infiltration (LIA; n=25) with ropivacaine and dexmedetomidine. Outcomes of interest included patient well-being using the Anasthesiolgischer Nachbefragungsbogen (ANP), length of stay, total range of motion (ROM), Knee Society Pain Score, Knee Society Function Score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), and Forgotten Joint Score (FJS) at 5 days, 6 weeks, and 1 and 2 years, postoperation. All outcomes were similar between the two groups with the exception of Knee Society pain scores at 5 days, which was significantly lower in the USRA group. Well-being was significantly better in the LIA group.