Eighty-one patients with knee osteoarthritis scheduled for primary TKA were randomized to tourniquet (n=42) or no tourniquet (n=39). The primary outcome was FJS-12 at 8 weeks. Secondary outcomes included quadriceps/leg-press strength (1RM), active ROM, stair climb test, pain (NPRS), opioid use (MME), estimated peri-operative blood loss, haemoglobin fall, operative time, knee circumference, and length of stay; outcomes were assessed pre-op, Day 1, 8 weeks, and 1 year. Overall, the results revealed no between-group difference in FJS-12 at 8 weeks. However, tourniquet use improved knee-extension strength at 8 weeks and reduced estimated peri-operative blood loss and Hb fall; other outcomes, including LOS, were similar. These findings suggest tourniquet use does not change early joint awareness but confers haemostatic benefits and small early strength advantages without clear downsides in other measured domains.