240 patients undergoing arthroplasty of the hip or knee were randomized to preoperatively receive erythropoietin and autologous donation (Group 1), erythropoietin alone (Group 2), or preoperative autologous donation alone (Group 3). Patients were then evaluated postoperatively for allogeneic transfusion requirements, hemoglobin values, and complications or adverse reactions. Patients in Group 1 had the lowest allogeneic transfusion rate at 11%, compared to 28% for Group 2 and 33% for Group 3. The results highlight the effectiveness of preoperative use of erythropoietin in association with preoperative autologous donation to reduce the need for allogeneic blood transfusion associated with total joint arthroplasty.