103 patients scheduled for total hip arthroplasty were randomized to intraoperatively receive the application of 3g tranexamic intra-articularly (IA-TXA), or simply receive saline. The purpose of this study was to evaluate the efficacy of IA-TXA in reducing transfusion rate and blood loss, without increasing the incidence of thromboembolic complications. The results demonstrated a significantly lower transfusion rate with IA-TXA compared to placebo saline, without a significant increase in the rate of VTE complication. Blood loss (total and drain volume) was also significantly reduced in the IA-TXA group compared to the placebo saline group.