Abstraction Background Total knee arthroplasty (TKA) was the procedure which is preform by orthopedic surgeons in end stage osteoarthritis knee patients who fail conservative treatment. Periarticular analgesia is one of the effective and safe technique used to reduce pain after surgery. However, the location and formula of the mixture have not yet been controversy. Recently, there were study comparing intraosseous analgesic injection which provide significant postoperative pain relief than control group. So the authors conducted this study to compare between periarticular and intraosseous analgesic injection in simultaneous bilateral total knee arthroplasty patients. Method The study is a two-arm, double-blinded,randomised controlled trial with Twenty-six patients(52 knees)who undergone simultaneous bilateral total knee arthroplasty.Primary outcome is post operative pain at 12 hour ,24hour and 48 hour by using Visual analog scale for assessment. Secondary outcome are postoperative range of motion at 24 and 48 hour, post operative blood loss and post operative complication. Discussion While periarticular analgesic is the standard practice .intraosseous analgesic injection is potential route for control post operative pain after total knee arthroplasty surgery. This study can offer better alternative route for analgesic injection.