General vs Spinal in Total Joint Arthroplasty (TJA)

Inclusion Criteria: * Patients undergoing a primary total hip or knee arthroplasty * Subjects must be capable of providing informed consent * English or Spanish speaking Exclusion Criteria: Patients with contraindications for spinal anesthesia such as: * Prior lumbar surgery with hardware insertion * Elevated intracranial pressure * Infection at the site of the procedure * Thrombocytopenia or coagulopathy * Severe mitral and aortic stenosis and left ventricular outflow obstruction * Severe spine pathology (spinal stenosis, spondylolisthesis, spondylosis) with radiculopathy and/or neurogenic claudication * Preexisting neurological disease Patients with contraindications for general anesthesia such as: * Congestive heart failure * Severe aortic stenosis * Patient is unable/unwilling to consent * Current pregnancy or women planning on becoming pregnant in the next year, and women who think they might be pregnant, or women who become pregnant during the study period will be removed from the study. * Prisoners