Three hundred and eleven patients with degenerative knee osteoarthritis or rheumatoid arthritis scheduled for primary total knee arthroplasty were randomized to receive either the limb occlusion pressure (LOP) method (n=154) or the systolic blood pressure (SBP) method (n=157) for determining tourniquet pressure. The primary outcome of interest was post-operative thigh pain. Secondary outcomes included knee range of motion (ROM), blood loss, wound complications, and the quality of the bloodless surgical field. Outcomes were assessed from postoperative days 1 to 3 and at six weeks. Overall, the study revealed that the LOP method required lower tourniquet pressures and resulted in significantly less post-operative thigh pain with better early postoperative knee ROM. The findings suggest that the LOP method optimizes tourniquet management, enhancing recovery after surgery.