To the Editor It is with great interest that we read the article “Efficacy of Liposomal Bupivacaine and Bupivacaine Hydrochloride vs Bupivacaine Hydrochloride Alone as a Periarticular Anesthetic for Patients Undergoing Knee Replacement: A Randomized Clinical Trial.”1 We find it encouraging that this large, relatively homogeneous trial has confirmed that the traditional form of bupivacaine is comparable on multiple outcomes such as opioid use, adverse events, and long-term functional outcome. In addition to clinical outcomes, traditional bupivacaine is also shown to be significantly more cost-effective compared with the liposomal vehicle.