Five randomized controlled trials were included in this meta-analysis investigating the efficacy and safety of combined intravenous-intraarticular tranexamic acid administration to that of intravenous tranexamic acid alone. Pooled results demonstrated significantly lower total blood loss, smaller postoperative hemoglobin drop, and lower incidence of transfusion in combined intravenous-intraarticular TXA groups compared to intravenous TXA alone groups. Incidence of thromboembolic complications did not significantly differ between administration methods.