Effect of Tourniquet Release Timing on Blood Loss, Surgical Time, and Wound Outcomes in Total Knee Arthroplasty: A Prospective Comparative Study

Background The timing of tourniquet release in total knee arthroplasty (TKA) remains a topic of debate, with studies suggesting varying impacts on blood loss, operative time, and wound healing. Despite widespread global research, data from our region are limited, and objective assessment tools remain underutilised. Methods We conducted a prospective comparative study involving 113 patients undergoing primary TKA. Patients were assigned to one of two groups: Group A (tourniquet released before wound closure) and Group B (released after closure). All surgeries were standardised in terms of technique, prosthesis, and personnel. Outcomes included post-operative haemoglobin drop, intra-articular haematoma volume (measured via ultrasound), operative time, and wound healing at one-week follow-up. Results There was no significant difference between the two groups in haemoglobin drop (p = 0.877), intra-articular haematoma volume (p = 0.794), or operative time (p = 0.051). No wound complications were observed in either group. Conclusion The timing of tourniquet release, before or after wound closure, did not significantly affect post-operative blood loss, haematoma formation, operative time, or short-term wound healing. Surgeons may safely individualise release timing based on preference and intraoperative factors, provided tourniquet pressure and duration remain within safe thresholds.