A Phase-III , single-center , double-blind , randomized , controlled clinical trial was performed to compare topical intra-articular TXA ( @ g of TXA in @ mL of physiological saline solution ) with two intravenous doses of TXA ( @ mg/kg in @ mL of physiological saline solution , one dose before tourniquet release and another three hours after surgery ) in a multimodal protocol for blood loss prevention .