184 patients undergoing unilateral total knee arthroplasty (TKA) were randomized to one of two tranexamic acid groups: an intravenous administration group, or a combined topical and intravenous administration group. Patients in the intravenous group were given 3g of tranexamic acid (TXA) intravenously during surgery. Those in the combined group had a solution composed of 1.5g of TXA and 50mL of normal saline irrigated into the wound after component implantation, and were also given 1.5g of TXA intravenously during surgery. Factors such as blood loss, transfusion rate, swelling ratio, and pain were assessed and compared between groups in the perioperative period up to 4 days. The results demonstrated significant effects of combined administration on maximum hemoglobin drop, postoperative blood loss to drain, pain on postoperative days 2-3, swelling on postoperative days 2-4, and satisfaction upon discharge.