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Julian Koettnitz, Filippo Migliorini, Christian D. Peterlein, Christian Götze

• \(\bf Introduction\) Total hip (THA) and knee arthroplasty (TKA) are surgical interventions for patients with primary and posttraumatic osteoarthritis. The present clinical investigation compared gender differences in THA and TKA. \(\bf Methods\) Data from 419 patients following primary THA and TKA were collected. The occurrence of systemic and surgery-related complications, the units of blood transfused, and the change in Hb were investigated. Hb was collected preoperatively and at 1, 2, 4 and 7 days postoperatively. Statistical analysis was performed using the software IBM SPSS 28. \(\bf Results\) There was no significant difference in surgery-related and general complications in men between THA and TKA. A significant difference between THA and TKA in systemic complications in women was observed. No significant difference between THA and TKA in related to surgery-related complications was evidenced. In men, no difference in Hb progression was observed. In women, a significant Hb drop was evidenced (\(\it p\) = 0.03). The rate of blood transfusion units in women was significantly greater in TKA than in THA (\(\it p\) = 0.001). No statistically significant difference was observed in men in the rate of transfusion between THA and TKA. \(\bf Conclusion\) Perioperative care should be organized differently for women and men. Furthermore, a differentiation between the procedures for each sex could prevent the occurrence of perioperative complicated courses.