Cao G, et al. - Researchers sought to determine the incidence and risk factors for blood transfusion in subjects who underwent simultaneous bilateral total hip arthroplasty (SBTHA) and simultaneous bilateral total knee arthroplasty (SBTKA). In order to establish specific, personalized transfusion risk assessments for patients, the risk factors for transfusion following SBTHA and SBTKA ought to be evaluated.The risk factors for SBTHA included female sex, lower BMI, inflammatory arthritis, American Society of Anesthesiologists (ASA) class ≥3, drain use, and increased intraoperative bleeding. Whereas the risk factors for SBTKA were ASA class ≥3, tourniquet use, drain use, and increased intraoperative bleeding. Transfusion risk could be decreased by increasing the preoperative hemoglobin (Hb) level. Furthermore, in order to decrease transfusion need in SBTHA, tranexamic acid was encouraged to be used.