Orthopedic joint replacement procedures, including total hip and knee arthroplasty, are crucial interventions for managing degenerative joint diseases and enhancing patients’ quality of life. Postoperative pain management remains a critical challenge affecting recovery and outcomes. Recognizing pain management as pivotal in patient care, this systematic review evaluates the effectiveness of patient-controlled analgesia (PCA) in orthopedic surgeries. This systematic review synthesizes the current literature to assess PCA’s role in orthopedic joint replacements. Studies focusing on pain relief, opioid consumption, hospital stays, rehabilitation outcomes, and patient satisfaction were analyzed. Significant findings were extracted from statistical analyses to evaluate PCA’s efficacy compared to traditional pain management methods. PCA significantly improves postoperative pain relief (p < 0.05), leading to a 30% reduction in opioid consumption and a 20% shorter hospital stay on average compared to traditional methods. Additionally, patients using PCA reported higher satisfaction scores (85% vs. 65%) and demonstrated improved rehabilitation outcomes, enhancing overall recovery and quality of life post surgery. This review underscores PCA’s effectiveness as a superior strategy for postoperative pain management in orthopedic joint replacements. By reducing pain, opioid use, and hospitalization duration and enhancing rehabilitation outcomes, PCA contributes significantly to improving patient outcomes and healthcare efficiency.