66 knee osteoarthritis patients scheduled to undergo a one-stage sequential bilateral total knee arthroplasty procedure were randomized to receive a femoral bone cutting performed using an accelerometer-based device which avoided femoral canal breaching (n=33) or a conventional technique with femoral canal breaching (n=33). The primary outcome of interest was total red blood cell (RBC) loss. Additional outcomes of interest included hematocrit level, drainage blood loss, blood transfusion rate, transfusion volume, morphine use, and length of hospitalization. No significant differences were observed between the two groups in all outcomes, suggested in the use of an accelerometer-based device, which avoids femoral canal breaching, may not provide any advantage in blood loss reduction vs. conventional techniques with femoral canal breaching.