With growing interest in minimizing opioid-related harms after knee or hip arthroplasty, tapentadol has emerged as a promising alternative in multimodal analgesia. Evidence on using tapentadol after knee or hip arthroplasty remains sparse, with only a handful of RCTs and small retrospective studies available. The randomized data so far show no meaningful differences in pain relief when tapentadol is included in multimodal analgesia compared with oxycodone, although patients receiving tapentadol consistently report fewer constipations. The limited sample sizes and varied designs make it hard to draw firm conclusions, but the early signals point toward comparable analgesia with a potentially better tolerability profile. More rigorous trials are clearly needed to understand where tapentadol fits within modern postoperative pain protocols.