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This article reviews anesthesia and perioperative pain management options for patients being treated for the stiff and painful knee. Common treatment procedures are divided into three categories based on the magnitude of the operative procedure. Intraoperative and perioperative anesthesia considerations are discussed for each surgical category, and the protocols used at the authors' institution are explained. The coordinated efforts of the orthopedic surgeon, anesthesiologist, nursing staff, and physical therapist in the treatment of patients with the stiff and painful knee are emphasized.