72 patients undergoing a high tibial osteotomy with a tourniquet were randomized to receive a conventional femoral nerve block (n=36) or a modified femoral nerve block with femoral artery block (n=36). The primary outcome of interest was the incidence of tourniquet hypertension, defined as an increase in systolic blood pressure >30% above baseline. Additional outcomes of interest included esmolol consumption, opioid consumption, patient-controlled analgesia pressing frequency, sleep disturbance, and pain on a Visual Analog Scale (VAS). The combined artery/nerve block resulted in a significantly lower incidence of tourniquet hypertension and esmolol consumption intra-operatively compared to conventional femoral nerve block. Hemodynamic outcomes increased 30 minutes post-inflation in both groups, but lower heart rate, mean arterial pressure and systolic blood pressure were observed in the combined group. No other differences were observed. The results suggest that a combined femoral nerve/artery block can mitigate tourniquet-related hypertension for patients undergoing high tibial osteotomy.