The purpose of this study was to compare the usage of positive and negative pressure hemovac drain according to blood loss and blood transfusion requirements in patients who diagnosed primary osteoarthritis and scheduled to undergo Total Knee Arthroplasty (TKA). Methods: Between January-May 2015 patients were reviewed retrospectively. Fifty patients who scheduled to undergo TKA were enrolled in the study. Patients were divided into two groups. In the first post operative day, hemovac drains

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... kept under positive pressure in the patients of Group I. In the second day, drains were removed by switching into a negative pressure after the passive range motion exercises. In Group II, it had been kept in negative pressure until the hemovac drain removed. Both groups underwent the same rehabilitation program after the surgeries. Age, gender and body mass index of patients were similar in both groups. Results: Preoperative value of hemoglobin (g/dl), hematocrit (%) and the number of erythrocytes (mm3) were similar in both groups. These values were also similar in both groups in the first four days after the surgery. The average blood loss from hemovac drain, and the amount of erythrocytes us pension used postoperatively were found similar statistically in both groups (p>0.05). Furthermore, 9 of the 24 patients in Group I, and 13 of the 26 patients in Group II were performed the allogeneic erythrocyte suspension transfusion, and the need for allogeneic transfusion in both groups were found similar statistically (p>0.05). Conclusion: Considering the consequences of the present study, early usage of the positive pressure hemovac drain does not reduce the amount of blood loss, the amount of transfused allogeneic erythrocyte suspension, and the need for allogeneic transfusion at the postoperative period.