OBJECTIVES: Postoperative blood-saving is high-priority after every planned surgery. The aim of this study was to analyse the effect of positioning of lower extremities on the postoperative bleeding after total knee replacement surgery. METHODS: Sixty patients from the orthopaedic department of Zala County Hospital who were operated on for insertion of a unilateral total knee prosthesis with cement and got autologous blood transfusion (age 35-80 years), were randomly assigned to three intervention groups. In Group I (n=20), patients were in normal laying position, in Group II (n=20), hips were positioned in flexion and knee in extension and in Group III (n=20), hips and knees were positioned in 30^o flexion in the first 6 postoperative hours. The surgical technique, the surgeon and the anticoagulant treatments were the same. Data collection: medical records, haemoglobin and haematocrit. For the clinical parameters, t-tests, ANOVA and Scheffe post hoc tests were used. Statistical significance was established at the α-level of 0.05, and IBM SPSS 20.0v was used. RESULTS: During the first six postoperative hours positioning not affected significantly on the volume of bleeding and recirculated blood volume (Group I: 615.0±247.3, Group II: 600.0±358.2, Group III: 715.0±392.3 ml, ANOVA: p=0.714; post hoc: p=0.995, p=0.805, p =0.751), either in hours 6-72 (Group I: 775.0±227.6, Group II: 762.0±332.8, Group III: 960.0±400.6 ml, p=0.335; p=0.996, p=0.462, p=0.414). Most units of homologous transfusion were needed in Group II (10 units). Position had not effect on the intensity of pain and value of the active range of motion of the knee (p= 0.682 vs. p = 0.585) either in haemoglobin and haematocrit values (p=0.362 vs. p=0.559). CONCLUSIONS: These results of the present study suggest that the postoperative positioning of the lower extremities after knee replacement not affected the postoperative bleeding, the pain and the range of motion of the knee joint.