الفهرس 
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Abstract
Summary and conclusion : Although that the tourniquet has the obvious advantage of a clear surgical field and should theoretically provide a shorter operative time in total knee arthroplasty, it has systemic effects as well as local effect on the limb. We found that the total and intraoperative blood loss are less when using a tourniquet which by turn this should reduce the need for blood transfusion. In contrast, we found that patients in touniquetless group had a significant less thigh pain, earlier straight leg raising, and slightly better ROM especially in extension in the early postoperative rehabilitation period. Although, those differences were not clearly defined at long term follow up. On the other hand, we also reported no significant differences between tourniquet and tourniquetless patients as regard WOMAC score, KSS score, TUG test and stair climbing test. In conclusion, from the results in this study for TKA surgery performed with and without tourniquet, no clear superiority for either of these procedures can be seen. However, with and without tourniquet use the level of the knee function, the patient satisfaction as well as the health status improved significantly. We hope that our study presented here will enable orthopedic surgeons to make an informed decision as to choose the use a tourniquet or not, according to the benefits and risks of each procedure and what suitable for patients health status.