Sixty-one patients with primary osteoarthritis of the knee were randomized to receive either intravenous TXA (n=30) or a combination of intravenous and intraarticular TXA (n=31). The primary outcome of interest was total blood loss (TBL). Secondary outcomes included a reduction in hemoglobin (Hb) levels, transfusion rates, and incidence of thromboembolic events (TE). Outcomes were assessed on the 3rd postoperative day and followed up for six months. Overall, the results of the study revealed that the combined use of intravenous and intraarticular TXA significantly reduced total blood loss and hemoglobin drop. No transfusions or thromboembolic complications were reported. The study suggests that combined intravenous and intraarticular TXA is superior in reducing blood loss and hemoglobin drop in TKA.