32 patients scheduled for bilateral total knee arthroplasty (TKA) were randomized to have the procedure of one knee performed under tourniquet control, with the procedure of the other knee performed with either limited tourniquet use or no tourniquet use at all. Outcomes of interest included quadriceps strength, quadriceps activation, hamstrings strength, unilateral limb balance, and clinical examination measures (knee range of motion, swelling, pain). Assessments were made preoperatively, at 3 weeks, and at 3 months postoperatively. The only significant between-group difference that was observed was in quadriceps strength, which was significantly lower at both 3 weeks and 3 months following procedures performed using a tourniquet versus procedures with limited or no tourniquet use.