 Namaskara. I am Dr. Marli Nath, orthopedic surgeon working in Manipal Hospital, Bangalore. Blood transfusion is not required nowadays unless patient has a low hemoglobin before the surgery. If he has got a less blood before the surgery, we have to transfuse the blood. Because in the manual invasive replacement surgery, the tissue damage will be less. Surgery takes less time and the blood transfusion is not required.