135 patients scheduled for total knee arthroplasty were randomized to three different hemostasis protocols with 2 hour postoperative drain clamping: 1) a 250mg intra-articular tranexamic acid (IA-TXA) injection (low-dose), 2) a 500mg IA-TXA injection (high-dose), or 3) a placebo injection. The purpose was to determine the effect of different TXA doses on reducing blood loss and transfusion needs. The results indicated that both TXA doses significantly reduced calculated blood loss and transfusion requirements compared to the placebo group. Furthermore, blood loss was similar between TXA groups, although fewer transfusions were needed in those who received 500mg TXA. The latter of the two findings may have been impacted by significantly lower preoperative hemoglobin levels in the 250mg TXA group.