This is a prospective randomized controlled study assessing the efficacy of tranexamic acid (TXA) to decrease postoperative autologous blood retransfusion in primary total hip and knee arthroplasty. The authors studied 98 patients and gave 1 g of TXA followed by another 1 g of TXA 3 hours later (TXA group). They found that the retransfusion rate of drainage blood was 10.2% in the TXA group and 85.7% in the control group. In addition, median blood loss during first 24 hours was significantly lower in the TXA group (320 mL), compared to the control group (970 mL), although the rate of allogeneic blood transfusion was not different between the groups. The authors conclude that addition of TXA to a restrictive transfusion protocol makes the use of a postoperative blood salvage system in patients undergoing primary hip and knee arthroplasty unnecessary. These results tell us that TXA can be useful, even in operations associated with moderate bleeding such as TKA and THA.