50 patients with pretreatment hemoglobin level of 100 to 130 g/L who were undergoing primary total knee reconstruction were randomized to receive standard care using preoperative autologous blood donation (PAD) or recombinant human erythropoietin (epoetin alfa) at 40 000 U (preoperative day 14). Blood counts were done every day for up to 5 days after the operation. From the day of surgery to two days post-operatively, the epoetin alfa group had significantly higher hemoglobin, hematocrit and reticulocyte counts than the PAD group. There was no difference between the two groups for the number of patients requiring a post-operative allogeneic blood transfusion or for the rate of adverse events.