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Background and Aims The increasing prevalence of knee joint replacement surgeries necessitates optimised pain management strategies that support Enhanced Recovery After Surgery (ERAS) pathways, minimise opioid consumption, and facilitate early discharge. This study evaluates the analgesic efficacy of a novel Peripheral Nerve Block Combination (PNBC, Group A) compared to the standard regimen (Group B) in patients undergoing Medial Unicompartmental Knee Arthroplasty (UKA) and Total Knee Arthroplasty without Patellar Resurfacing (TKA-WPR) in an ambulatory setting. Group A received: 1. Genicular nerve block (GNB) of the superomedial, superolateral, inferomedial, and inferolateral genicular nerves 2. Interspace between the popliteal artery and capsule of the knee (IPACK) block 3. Distal femoral triangle block (DFTB) of the saphenous nerve and the nerve to vastus medialis 4. Medial and intermediate femoral cutaneous nerves of the thigh block (MFCN, IMFCN) 5. Periarticular local anaesthetic infiltration (PALAI) Group B received: 1. Adductor canal block (ACB) 2. PALAIMethods This single-centre retrospective cohort study analysed two matched groups over one year (31 UKA, 31 TKA-WPR per group). Matching was performed using Opera theatre software (GE Healthcare) to ensure comparability. Standardised anaesthetic, surgical, and postoperative analgesia protocols were applied across both groups. Primary outcome: total morphine consumption. Secondary outcomes: hospital discharge time and postoperative block-related motor weakness.Results Group A demonstrated a 64.71% and 39.39% reduction in morphine consumption for UKA and TKA-WPR, respectively. Same-day discharge was achieved in 77.4% (UKA) and 45.2% (TKA-WPR) of Group A patients versus 45.2% and 12.9% in Group B. No postoperative motor weakness was reported in either group.Conclusions The novel PNBC significantly reduces postoperative opioid use and facilitates earlier discharge without increasing motor block risk, optimising ERAS pathways and improving patient outcomes following knee arthroplasty.