Four hundred and thirty-eight patients who were scheduled to undergo a hip or knee arthroplasty were randomized into individualized hemodynamic management using the pleth variability index or standard hemodynamic management. The primary outcome of interest was hospital length of stay. The secondary outcomes of interest included the following: theoretical hospital length of stay, serious postoperative cardiac complications, acute postoperative renal failure, postoperative troponin Ic, and arterial lactate measurements. No significant differences in all outcomes were observed between the two groups.