31 randomized controlled trials were included in this meta-analysis which was conducted with the intention of comparing systemic (intravenous (IV)) and topical (intra-articular (IA)) administration of tranexamic acid (TXA). Outcomes of interest included total blood loss, rates of transfusion, and incidence of thromboembolic events. Upon analysis of the data, it was found that there was no significant difference between the intravenous and topical application of TXA, and both were superior to the control. Furthermore, neither method of TXA application was associated with an increase in thromboembolic complications when compared to the control.