73 patients scheduled for total knee arthroplasty were randomized to determine the efficacy of topical tranexmic acid for the management of perioperative blood loss. Patients received a topical administration of either 2.0g of tranexmic acid in 75mL of saline, or 75mL of saline alone. Perioperative results indicated that patients who were treated with tranexamic acid experienced significantly lower blood loss, higher postoperative hemoglobin levels, and lower hemoglobin loss. There was no difference between the two groups in venous thromboembolism rate.