Introduction: The aim of our study is to reveal risk factors and diseases that cause secondary osteoporosis in male patients and the effect of medical intervention at the Outpatients Clinic.

Patients and Methods: Our study performed from January 2005 until December 2008 and included 100 men, with age> 55 years with confirmed osteopenia or osteoporosis, and other risk factors for fracture. All patients underwent laboratory studies- blood test, ESR, creatinine, SGOT, SGPT, serum calcium, alkaline phospatase. Additionally to the above more specific studies were performed, serum testosterone, LH, TSH, urinary calcium and cortisol, PTH,25(OH)D. These studies took place in order to investigate potential secondary causes of male osteoporosis.

Results: In 48% of the patients investigated some secondary cause was detected [ 14 patients had Cushing syndrome(30%), 22 obtained steroids(45%), 10 patients were alcoholic(20%), 2 patients had nutrition diseases(5%)]. Originally our aim was arsis of the secondary cause of osteoporosis, improvement of calcium intake and avoidance of smoking and alcohol abuse. After four years follow up, we noted an improvement of BMD, 8.2% on the vertebral column and 6.1% at the hip joint.

The rest of our patients, 52%, had idiopathic osteoporosis and with the administration of 70mg of aledronate, once a week with the combination of calcium and Bit D they had an improvement of BMD, 7.48% on the vertebral column and 5.5% at the hip joint.

Conclusion: The diagnostic approach of a male with osteoporosis in the Outpatients clinic has to focus not only on the detection of the patients with increased risk factors for fracture but also on the selection of the appropriate treatment as well as in the exclusion of secondary osteoporosis.

We compared blood transfusion for three groups of patients undergoing total knee arthroplasty (TKA). Patients were randomized to receive either their post operative wound drainage as an autotransfusion We used an autotransfusion system with anticoagulant in one group (n=28) and an other one without anticoagulant in the other group (n=28). Allogeneic blood was transfused in patients of either group whose haemoglobin fell bellow 9 gr/dl. Only 2% of patients in two autotransfusion groups required an allogeneic transfusion compared with 82% in the control group (n=28 without any autotransfusionsystem). We compared Ht, Hgb, WBC, SGOT, SGPT, Bilirubin and D-dimers test before, one, three and seven days post-operative. We also compared the patients temperature before and after auto or allogeneic transfusion. There was no hospital mortality and the patients costs were lesser in the autotransfusion group. We conclude that in TKA postoperative autotransfusion is a safe, effective economic method and the most of all reduces allogeneic blood use.