One thousand one hundred and sixty-two patients with symptomatic hip osteoarthritis were randomized to receive a total hip arthroplasty with the use of a post-surgical closed suction drain (n=635) or no drainage (n=527). The outcomes of interest included hemoglobin and hematocrit levels, drainage volume, operative duration, blood transfusion rate, Harris Hip Score (HHS) and Short Form 36 (SF-36) physical component score at 1 year post-surgery, wound infection rate and pain severity on a Visual Analog Scale (VAS) 24 hours post-operation. Results revealed a significantly greater drop in hemoglobin and hematocrit levels 24 hours post-operation, as well as greater need for blood transfusion in the drainage group. VAS pain scores were, however, slightly lower in the drainage group 24 hours post-operation. No significant differences in operative time, wound infection rate, HHS scores, or SF-36 physical component scores were observed.