Pre vs Post Block in Total Knee Arthroplasty (TKA)

Inclusion Criteria: 1- Patients 18 or older 2 - Patients undergoing primary total knee replacement at the University of Miami Hospital 3 - Patients that have capacity to provide medical consent Exclusion Criteria: All patients under the age of 18 Prisoners, uncontrolled diabetics, increased risk of bleeding, pregnant women, women planning on becoming pregnant in the next year, and women who think they might be pregnant. Patients with prior surgery or history of infection on the joint of interest. Patients on steroid preoperatively. Inability to provide medical consent. Patients with a history of significant unmitigated pain in parts of their body not including the knee the procedure is to be performed or a history of pain catastrophizing (the tendency to magnify the threat value of the pain stimulus and to feel helpless in the context of pain, and by a relative inability to inhibit pain-related thoughts in anticipation of, during or following a painful event) regarding pain anywhere in the body. Any condition that, in the opinion of the investigator, would compromise the well-being of the patient or the study or prevent the patient from meeting or performing study requirements will exclude the participant. Allergy to local anesthetic or any medication used in the standard protocol for joint replacement.