Intra-articular Tranexamic Acid in the Reduction of Blood Transfusions in Primary Total Hip and Total Knee Arthroplasty

Inclusion Criteria: * with osteoarthritis * scheduled for elective primary unilateral THR or TKR * provided informed consent * can read, write and speak English Exclusion Criteria: * history of arterial or venous thromboembolic disease (myocardial infarction, symptomatic ischemic heart disease, atrial fibrillation, cerebrovascular accident, deep-vein thrombosis, pulmonary embolus, or thrombogenic cardiac valvular disease or rhythm disease) * pre-operative Hg of \<120 g/L * Known allergy to Tranexamic Acid * Coagulation disorder * Acquired disturbances of color vision * Hepatic insufficiency, any history of liver disease * Renal insufficiency (on dialysis) * Preoperative prophylactic use of antiplatelet or anticoagulant therapy such as Clopidogrel, Warfarin, dabigatran or Rivaroxaban. This does not include low dose Aspirin (81mg) * Patients with a history of subarachnoid hemorrhage \[20\] * Simultaneous bilateral THA or TKA * Any contra-indication for spinal anesthesia * Allergy to Celecoxib, which will be the only nonsteroidal anti-inflammatory drugs (NSAID) used in the multi-modal analgesia regime. * Retinal vein or retinal artery occlusion * Female on oral contraceptive pills and/or premenopausal * Concurrently taking hydrochlorothiazide, desmopressin, sulbactam-ampicillin, carbazochrome, ranitidine and/or nitroglycerin for the duration of the surgery.