Seven studies (6 randomized controlled trials; 1 prospective comparative study) were included in this systematic review examining the effect of postoperative limb position on blood loss and range of motion after total knee arthroplasty. With respect to blood loss measures, four studies reported no significant difference between flexion and extension protocols, whereas flexion was favoured in two studies, and extension was favoured in one study. With respect to range of motion, three studies reported no significant differences between groups, whereas three remaining studies reported significantly higher range of motion with flexion protocols within the first week of surgery and up to 6 week after surgery.