PURPOSE: To assess clinical difference between total knee replacement (TKR) performed with tourniquet and diluted adrenine infiltration without tourniquet. MATERIALS AND METHODS: We analyzed the postoperative transfusion amount, intraoperative blood loss, operation time, range of motion and postoperative thigh pain in 60 cases. 30 cases (group I) were performed TKR with tourniquet and the others (group II) were performed TKR using diluted adrenaline (2.5mg of 1:1000 epinephrine diluted in 500 ml of normal saline) infiltration without tourniquet. Closed suction drainage was not used in all patients. RESULTS: In gruop I, the intraoperative blood loss was average 407.6 ml, pre- and postoperative hemoglobin average 12.6 and 9.4 g/dl, postoperative transfusion average 1.83 unit, operative time average 116.5 minutes and range of motion (at preoperative, at 7days and 6 weeks after the operation) average 116.3 degrees, 90.7degrees and 103.4degrees. In group II, the intraoperative blood loss was average 398.2 ml, pre- and postoperative hemoglobin average 13.1 and 9.7 g/dl, postoperative transfusion amount average 1.76 unit, operative time average 118.3 minutes and range of motion average 113.6 degrees, 89.2 degrees, and 105.7degrees. But average postoperative thigh pain score was significantly higher in group I (average 3.7) than group II (average 0.9). CONCLUSION: There was no significant difference in intraoperative blood loss, pre- and postoperative hemoglobin, postoperative transfusion amount, operative time and range of motion between the two groups. But we could decrease the thigh pain after TKR, not using the tourniquet.