PURPOSE: To assess the efficacy of unilateral use of a blood reinfusion device in one-stage bilateral total knee arthroplasty (TKA). MATERIALS AND METHODS: We carried out a retrospective cohort study on 100 patients having one-stage bilateral TKA. In 50 of these patients (study group), a blood reinfusion device was applied on one knee and a standard suction drain on the other, and they were compared with 50 matched controls who received bilateral suction drains (control group). The hemoglobin (Hb) level, the hematocrit (Hct) and the platelet count were checked preoperatively, immediately postoperatively, and the third and seventh days postoperatively. The total drain output and the amount of allogeneic blood transfusion were also compared. RESULTS: There were no significant differences in the total drain output and required amount of allogeneic blood transfusions between groups (p>0.05). However, the study group had significantly lower Hb and Hct values by the first day postoperatively and significantly lower platelet count values by the third day postoperatively than the control group (p<0.05). CONCLUSIONS: Compared with use of bilateral suction drains, unilateral use of reinfusion device was not advantageous in reducing allogeneic transfusion in one-stage bilateral TKA.