70 patients with stage 3-5 gonarthrosis were randomized to undergo total knee arthroplasty (TKA) with or without the application of a tourniquet. The purpose of this trial was to determine whether TKA should be performed with or without the use of a tourniquet, based on functional and clinical outcomes at one year postoperatively. Results revealed that TKA without the use of a tourniquet significantly improved KOOS functional outcomes and knee range of motion up to 8 weeks after surgery, but resulted in greater intraoperative bleeding compared to TKA using a tourniquet. However, neither group required transfusion following TKA.