Knee replacement surgery is an efficacious and technically mature technique that is increasingly recognized by a wide range of physicians and patients. However, primarily due to the fear of post-operative pain, many patients are afraid to undergo the surgery and instead have to endure the pain associated with knee disease. Indeed, in the early days of knee replacement surgery, doctors had little experience with how to manage post-operative pain after knee replacement, and some even took these post-operative pains for granted. In recent years, many of these misconceptions have been corrected as the understanding of postoperative analgesia has improved. In the field of postoperative analgesia for knee replacement, our department has also made a lot of useful explorations and achieved very satisfactory results. Patients who have undergone knee replacement surgery in our department have experienced a significant decrease in postoperative pain and have been very satisfied with the results and speed of recovery from the surgery. What have we done in terms of analgesia for knee replacement surgery? First of all, we use analgesics in advance, giving oral analgesics 1-2 days before the surgery. This has the advantage of increasing the patient’s pain threshold prior to surgery, which can effectively reduce postoperative pain. Next, the surgery is performed using a medial approach via the medial femoral muscle. Previously, the conventional incisional approach to perform knee replacement surgery was to cut the medial femoral muscle and rectus femoris. The incision of the medial and rectus femoris muscles is equivalent to cutting the most important muscle in the front of the knee (quadriceps) in half, which will lead to increased postoperative pain, muscle atrophy, and decreased muscle strength. This pain will be exacerbated by the contraction of the muscle. The rehabilitation effect of the patient’s surgery will also be affected. We use a medial approach through the medial femoral muscle to perform the surgery, which does not require dissection of the quadriceps muscle, but only requires pulling the quadriceps muscle as a whole to perform the surgery, with low postoperative pain and ideal recovery results. Again, we minimize the use of tourniquets during surgery. A tourniquet is an inflatable bag that is tied to the root of the thigh during surgery, which temporarily keeps the entire leg bloodless when inflated. However, the use of a tourniquet is a double-edged sword; it has the benefit of less bleeding during surgery, but it can lead to postoperative deep vein thrombosis, swelling, and increased postoperative pain. We do not use tourniquets during the first half of the procedure. Although the operation will take a little longer and there is some bleeding during the operation, the intraoperative blood transfusion allows the bleeding from the operation to be recovered and filtered back into the patient, and the bleeding will be significantly reduced after the operation. We only use a tourniquet for a short time during the second half of the surgery when the artificial joint prosthesis is fixed with bone cement. Also, every effort is made to be minimally invasive during the surgery. We don’t consider a small incision to be minimally invasive; minimally invasive is a concept that is carried out throughout the surgery and in all anatomical structures, not just in the skin. If a 2 cm increase in incision can reduce the trauma to more important internal structures, it is well worth it. In addition, we use a local infiltration injection of “analgesic mix” prior to the surgical closure of the incision, which is also very helpful for postoperative analgesia. The “analgesic mix” includes: bupivacaine, dexamethasone, epinephrine, antibiotics, etc. Finally, the use of analgesics in the postoperative period should be regular and early. There is no need to tolerate pain, and analgesics should be used promptly whenever there is the first sign of pain. The use of analgesics does not affect the therapeutic effect.