This prospective randomized controlled trial was conducted To compare the efficacy of TNA in terms of total blood loss and the allogenic transfusion rate among the three study groups; intravenous alone, combined intravenous and low dose topical TNA and combined intravenous and high dose topical TNA.

To evaluate the safety of each regimen in view of deep vein thrombosis and venous thromboembolism.

Inclusion Criteria:

• patients with diagnosis of primary osteoarthritis

Exclusion Criteria:

• patients with diagnoses other than primary OA
• patients on anticoagulation therapy
• patient with chronic renal failure
• patient with CVA Hx
• Patient with seizure Hx
• Patient with severe CHF
• Patient with acquired or congenital coagulopathy