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Registry data report an incidence of local anesthetic systemic toxicity (LAST) of 1.8 per 1000 in peripheral nerve blocks, 1 but the incidence of LAST associated with local infiltration anesthesia (LIA) for total joint arthroplasty is unknown. The primary aim of our study was to determine the incidence of LAST associated with LIA following total knee arthroplasty (TKA) and total hip arthroplasty (THA) at our hospital.