6 randomized controlled trials were included in this meta-analysis examining the efficacy of tranexamic acid (TXA) through intra-articular administration when compared to placebo, no TXA administration, or intravenous TXA administration. Efficacy was evaluated through blood loss, transfusion rate, and hemoglobin and hematocrit drop, and safety was assessed through the incidence of venous thromboembolic (VTE) complications. Results demonstrated topical TXA significantly reduced blood loss (total and postoperative drainage), mitigated hemoglobin drop, and reduced the rate of transfusion when compared to placebo/control. The risk of deep vein thrombosis was not revealed to be significantly increased with the use of topical TXA when compared to placebo/control.