Transcutaneous electrical nerve stimulation (TENS) has been used to treat chronic pain syndromes and has been reported to be of some utility in the treatment of postsurgical pain. A randomized, blinded, placebo-controlled trial was designed to evaluate the utility of TENS after total knee arthroplasty. Patients were randomly enrolled into patient-controlled anesthesia (PCA) alone, PCA plus TENS, or PCA plus sham TENS. The cumulative dose of morphine by PCA for each group was used as the end-point of the study. There was no significant reduction in the requirement for patient-controlled analgesia with or without TENS. We conclude that there is no utility for TENS in the postoperative management of pain after knee arthroplasty.