This study examined the efficacy of the Solcotrans (Solco Basle Ltd, United Kingdom) drainage system in the retransfusion of filtered drainage blood in total knee arthroplasty (TKA) patients. A study group of 58 TKA patients who received autologous blood reinsfusion was compared with a control group of 59 TKA patients who did not receive autologous blood reinfusion. Results showed that the number of patients who needed homologous blood transfusion was reduced from 78% in the control group to 34% in the study group. The complication rate was low. We conclude that postoperative retransfusion of small to moderate volumes of drainage blood can be used safely in clinical practice to decrease the need for homologous transfusion.