Inclusion Criteria:  Patients scheduled for primary total knee arthroplasty with American Society of Anesthesiologists (ASA) physical status I -III, mentally competent and able to give consent for enrollment in the study.  Exclusion Criteria:  Patient younger than 18 years old or older than 70 years old Allergy to local anesthetics, systemic opioids (fentanyl, morphine, hydromorphone, and any of the drugs included in the multimodal perioperative pain protocol. Revision surgeries were excluded. Impaired kidney functions and patients with coagulopathy were also excluded. Chronic pain syndromes and patients with chronic opioid use defined as the use of regular daily doses of systemic narcotics for the past 6 months prior to the surgery. BMI of 40 or more Pregnancy (positive urine pregnancy test result in Preop area on the morning of surgery)