200 patients scheduled for unilateral total knee arthroplasty (TKA) were randomly allocated to 4 groups to determine if there is a difference in efficacy between different administration methods of TXA. In group 1, 500 mg TXA was administered intravenously. In group 2, the joint was irrigated with 3 g of TXA in 100 cc of saline. In group 3, 1.5 g of TXA was injected through the drain and group 4 did not receive TXA. Over 48 hours postoperatively, all groups except group 1 had patients that required transfusions, although this was not statistically significant. Among all the TXA administration methods, intravenous injection of TXA was most effective in mitigating post-operative Hb drop whereas TXA injection by drain was the most effective in reducing postoperative blood loss to the drain.