What anesthesia is best for knee replacement surgery?

General: I would want to be "out" for this procedure.It is a major piece of surgery.

Regional or General: Either regional (spinal or epidural) or a general anesthetic can be used safely.

A combined technique: The most eloquent technique is a combined general anesthetic/nerve block approach. Before surgery you get a femoral and sciatic nerve block. This numbs up your whole leg and provides excellent post-op pain control. Some centers will also place a femoral block catheter so you can get more local anesthetic after the operation. Then the general anesthetic keeps you blissfully asleep during surgery.

Regional anesthesia: The preference is sometimes driven by the surgeon, but commonly the choice is a regional anesthetic. There seems to be some benefits with regards to postoperative thrombosis and pain management.