This study tests two types of pain relief methods after a Total Knee Replacement (TKA). The procedures involve blocking certain nerves to reduce pain. One method adds an anterior cutaneous nerve block, which involves numbing a small nerve near the skin's surface, to the standard adductor canal block. Adductor canal block numbs nerves in the leg. Two questions are asked: (1) Is the combination of methods better at reducing pain after surgery? (2) Does it lessen pain where a surgical drain is placed?

Participants will be divided into two groups: one receiving the adductor canal block and the other receiving both blocks. Pain levels, muscle strength, and medicine use will be monitored for 24 hours after surgery. Participants must be having a TKA with spinal anesthesia and fall into categories ASA 1-3, which measures health status. Those allergic to bupivacaine (a numbing medicine) or with blood clotting problems cannot join.

• Study involves monitoring over 24 hours post-surgery.
• Participants will be divided into two different treatment groups.
• Excludes those with bupivacaine allergy or blood clot issues.