36 patients scheduled for total knee arthroplasty were randomized to either postoperative closed suction drainage or nondrainage. Patients were assessed during hospital stay for hemoglobin (Hb) levels, pain, knee range of motion, and knee circumference, as well as at follow-up of 6 weeks, 3 months, 6 months, and 12 months related to knee range of motion, the Knee Injury and Osteoarthritis Outcome Score, and the Oxford Knee Score. Hb drop postoperatively was significantly greater in the CSD group compared to the nondrainage group. No significant differences were observed in knee range of motion between groups. Numeric rating scale pain scores during hospital stay to 10 days were significantly lower in the CSD group compared to the nondrainage group, and significance continued on the KOOS Pain score at 6 weeks and 3 months. From 6 to 12 months, no significant differences in patient-reported outcome scores were demonstrated between groups.