PURPOSE: The purpose of this systematic review and meta-analysis of randomised controlled trials is to assess the effectiveness of no drainage when compared to drainage in total knee arthroplasty, in terms of recovery of knee flexion, reduction in swelling, length of hospital stay and haemoglobin levels following TKA. METHODS: Six randomised controlled trials were included. RESULTS: There is no significant difference between the individuals who receive a drain and those who do not across any of the measures examined (p < 0.05). This analysis demonstrates no statistical difference in ROM [mean difference 0.03 degrees (95 %CI -1.51 to 1.45, p = 0.64, I(2) = 0 %)]. , nor in knee circumference [mean difference 1.63 cm (95 % CI -1.07 - 4.34 cm, p = 0.34), [I(2) = 0.12]. CONCLUSION: The finding raises the possibility that drains are not required to assist in recovery following TKA.