64 patients undergoing total knee arthroplasty (TKA) were randomized to have their tourniquet inflated either from incision (whole-course group) or from osteotomy (half-course group) until the leg was wrapped with elastic bandages. The purpose was to compare these two strategies with respect to blood loss, pain, functional outcomes, and the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE). The half-course tourniquet strategy was associated with decreased postoperative and calculated blood loss compared to the whole-course approach. No differences were noted between the two approaches with respect to intraoperative blood loss or the incidence of occult deep vein thrombosis. Furthermore, pain and functional outcomes, measured over 7 days post-operation, with half-course tourniquet use were either similar to or better than those obtained with the whole-course tourniquet approach.