Seventy-eight patients with osteoarthritis undergoing primary total knee arthroplasty were randomized to receive either intravenous tranexamic acid or intra-articular tranexamic acid. Outcomes included post-operative blood loss, measured by drain output, hemoglobin level drop, and the need for blood transfusion. Outcomes were assessed immediately after surgery and at 12 and 24 hours post-operatively. Overall, the results of the study revealed no significant difference between the two groups in terms of mean drain output or fall in hemoglobin levels at any time point. Similar rates of blood transfusion were also reported. The study concluded that both intra-articular and intravenous tranexamic acid are equally effective in reducing post-operative blood loss in patients undergoing primary total knee arthroplasty.