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Surgeons have adopted a variety of blood conservation strategies in an effort to reduce intraoperative bleeding and the need for postoperative transfusions after total knee arthroplasty. Despite meticulous surgical technique and the use of conventional electrocautery, there remains both visible and hidden blood loss at the time of surgery. Devices that afford the surgeon more control over active intraoperative bleeding potentially reduce the need for postoperative blood transfusions, reduce associated comorbidities related to blood loss, and improve the patient’s recovery. Saline-cooled bipolar transcollation is a safe and effective device for reducing the postoperative blood loss and in turn the need for postoperative blood transfusions.