Seventy-six patients with advanced knee osteoarthritis scheduled for primary unilateral total knee arthoplasty (TKA) were randomized to receive cryotherapy (n=26), intravenous tranexamic acid (TXA; n=25), or standard cold packs (control; n=25). The primary outcome of interest was acute postoperative blood loss (serial Hb/Hct). Secondary outcomes included VAS pain, knee flexion/extension, and coagulation indices (PT/INR). Outcomes were assessed pre-op and at 6, 24, and 48 hours. Overall, the results showed TXA significantly limited perioperative blood loss versus control, while cryotherapy achieved the lowest pain scores at all time points and preserved early knee motion. These findings suggest using TXA for hemostasis and cryotherapy for analgesia/ROM can enhance immediate recovery after TKA.