19 randomized controlled trials comparing the efficacy of postoperative cell salvage and standard suction drain techniques in patients undergoing total hip or knee arthroplasty were included in this meta-analysis. The purpose of the study was to determine the hematological and clinical efficacy of postoperative cell salvage in total joint replacement. Results showed that postoperative cell salvage reduced allogenic blood transfusion requirement (primary outcome) and increased hemoglobin levels compared to a standard suction drain. No significant difference in length of hospital stay, functional outcomes or the incidences of febrile reaction, wound infection or deep venous thrombosis were found.