Cao G, et al. - Since total knee arthroplasty (TKA) had always been consecutively observed with massive blood loss, which enhances the risk of anemia and allogeneic blood transfusion, resulting to higher incidence of wound complications, immunologic reactions, transmission of disease and delaying functional recovery,therefore, via a multicenter retrospective study of a total of 575 subjects, the researchers assessed whether tranexamic acid (TXA) administration could decrease blood loss and transfusion risk following simultaneous bilateral TKA (SBTKA). Patients were randomized into three groups on the basis of TXA usage, including intravenous (IV) group, combined group and control group. The mean total blood loss in control group were greater than that in IV group and combined group. The maximum hemoglobin and hematocrit drop in combined group and IV group were lower in comparison to those in control group. However, the difference between IV and combined groups was not marked. On drain volume, length of stay and hospitalization expenses, similar trend was discovered. Among the three groups, the incidence of complications did not differ very markedly. Hence, it was concluded that TXA could decrease blood loss with no apparent elevation in the incidence of complications during SBTKA.