Seventy-one patients (79 knees) undergoing total knee arthroplasty (TKA) were randomized to either have the tourniquet inflated throughout the procedure or during the cementation phase only. The purpose of this study was to compare the two protocols with respect to operative time, blood loss, as well as postoperative clinical and functional outcomes. Results indicated that there were no statistically significant differences in postoperative pain, blood loss, range of motion, or operative time between groups. Patients in the cementation tourniquet group reported similar rates of complication compared to the operative tourniquet group.