81 patients scheduled for simultaneous bilateral total knee arthroplasty were randomized to one of two groups: combined intravenous(IV)-intraarticular(IA) tranexamic acid (TXA) or placebo saline administration. The purpose of this study was to determine the efficacy of a combined TXA administration protocol for reducing blood loss postoperatively. Blood drainage, hemoglobin levels, and transfusion rates were assessed. Results demonstrated a significantly lower volume of blood drained after 24 hours in the TXA group compared to the placebo group, as well as a significantly smaller drop in Hb levels. Transfusion rate was 17.1% in the TXA group and 32.5% in the placebo group, though the difference was not statistically significant.