A randomised controlled trial comparing knee replacement cases with or without tourniquet use has demonstrated that using the tight cuff around the thigh actually causes muscle weakness after the surgery.  Tourniquet’s originate from battlefield surgery, where they might be life saving.  For elective surgery though, it’s not so obvious that it is necessary.  In the trail, published in CORR, the total blood loss was not significantly different between the two groups.

One of our anaesthetists five years ago suggested we abandon the unnecessary tourniquet.  Our observation prior to changing policy was that our LIA (Local Infiltration Analgesia) mixture saw the patients have more pain from the tourniquet site than the knee replacement.  We then abandoned tourniquet use all together, and the recovery from knee replacement has seemed to be easier since.  The published study has flaws, but the right idea.

For your reference:
Clinical Orthopaedics and Related Research®
January 2016, Volume 474, Issue 1, pp 69-77

~ Mr David Mitchell