Previous published research has shown promising results with flexion splinting post total knee arthroplasty. Before instituting this practice, we conducted a randomised controlled trial to confirm any benefits over splinting in extension. Five patients were recruited into the trial. 5 were excluded. The flexion group consisted of 49 patients who had their knee placed in 70° of flexion over an inactive CPM machine for 24 h post operation. The extension group consisted of 46 patients who were splinted in full extension for the first 24 h post operation. We assessed post-operative day 1 drain volume, haemoglobin and haematocrit, blood transfusions, duration of inpatient stay, range of motion and complications within 6 weeks of surgery. There was no significant difference between the two groups among any of the outcomes measured. As such, we have been unable to demonstrate any benefit with splintage in flexion post total knee arthroplasty and have not adopted it as part of our post-operative management.