Does Knee Replacement Surgery Hurt? What to Expect Before, During, and After Recovery
Key takeaways:
It’s typical to have pain in the first few weeks after knee replacement surgery, but it improves over time.
Medications, ice packs, and exercise help with recovery from knee replacement surgery.
It may take a year to fully recover from the surgery, but many people experience significant improvements in mobility and pain relief sooner.
Pain is a given before and after knee replacement surgery. But a combination of medication, exercise, and determination can help.
Common reasons people have knee replacement surgery include different types of arthritis that don’t respond to medication. These types of arthritis can cause chronic inflammation and knee pain with everyday tasks.
According to the American Academy of Orthopedic Surgeons, more than 700,000 total knee replacements are performed each year in the U.S. Most are done on people who are between the ages of 50 and 80.
If you’re considering knee replacement surgery, start by consulting with your primary care physician to see if it could be the right option for you. And keep reading to find out why three people underwent the procedure and how they managed their pain during recovery.
Following a recovery regimen became a full-time job
Sue Talbert, a 74-year-old personal trainer in Chicago, had her second knee replacement in May 2024 after living with severe arthritis.
Sue’s first knee replacement, in September 2023, had fewer complications than the second, which involved bone spurs and cysts. But despite the challenges, she approached recovery with a positive mindset.
After the procedure, she took opioids for a week to manage the pain. Then, she switched to high-dose acetaminophen (Tylenol) and a lot of ice packs. She also diligently followed a prescribed exercise routine.
She credits her attitude with getting her through. In addition to being grateful that she only has two knees, she says, she told herself, “It’s going to get better. It takes time, and it takes a lot of work, and the work can be very painful.”
What do people wish they knew before getting knee replacement surgery? Read one person’s thoughts on the value of an experienced provider and their tips for adjusting to life with a new knee.
What to expect after knee replacement surgery: In this story, three people explain what it was like to recover from having knee surgery.
How to save on joint surgeries: This personal essay details how one woman saved by scheduling three joint surgeries in the same year.
A lot of that work went into her physical therapy routine. “You have to do it every day — several times a day — and it becomes a full-time job,” she says.
Sue’s doctors told her that complete recovery takes a year. But after 4 months, she considered herself 100% recovered, even if her doctor might not have completely agreed. “I am doing everything I was hoping to do in terms of my movement,” she explains.
For people trudging through their own postsurgical pain, Sue’s advice is: “Think positive. Know that it’s going to be hard and uncomfortable, and you won’t want to do all the exercises, but you have to be gritty.”
When the doctor said it would hurt, he wasn’t wrong
Rod Richey, who’s 67 and lives in Greenfield, Indiana, had knee replacements in 2021 and 2024 after enduring severe pain for years. He says, at some points, the pain would get so bad that he would be on the verge of tears.
Rod remembers asking his doctor before the first surgery, “Will it hurt a lot?” And he still laughs years later when he recalls his doctor’s immediate answer: “Oh, hell yes.”
Rod’s doctor told him his knee looked “like a bag full of gravel with bone spurs and bone fragments.” And he warned Rod — for good reason, it turned out — about the first weeks after surgery.
“It hurts a great deal. But every day it’s a little less,” Rod says of the recovery process. “Then, there comes a day when you see something’s missing: the original pain you had before the surgery. And you can move better than you did before.” For Rod, getting to that point took about a month.
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The decision to replace his left knee was made more clear when it became painful for Rod to climb stairs. The second surgery was better, he says, “because I knew what was coming.” And though medication regimens vary from person to person, Rod and his doctor found a treatment plan to control his pain, allowing him to take opioids for less than a month.
Now, 3 years after his first surgery, Rod says, “there’s no pain at all” in his right knee. He has some residual pain and weakness in his left knee and uses a cane occasionally. But his doctor told him full recovery typically takes about a year.
Rod acknowledges he hasn’t always stuck to the prescribed exercise regimen, but he is convinced of its benefits. His advice to people undergoing a knee replacement is: “Don’t be brave. Take the meds. Do the exercises. It’s a process. It will get better.”
He put off surgery for years, but now he feels like ‘a new man’
Tom Hartos, who’s 59 and lives in Raleigh, North Carolina, had both knees replaced in 2023 after years of worsening pain.
The wear on Tom’s knees started when he joined the Marines as a cook at the end of high school and worsened over decades of working as a chef in the Corps.
“You're in deserts and cold ground in Korea and rocky beaches,” he says of standing all day on terrain that took a toll on his knees.
After his service in the Marines, he went to culinary school and eventually became an executive chef. By 2014, he says, the pain in his left knee was sharp, and he couldn’t bend it when it was inflamed. Imaging showed he had a torn meniscus, a band of cartilage around the knee. The pain got progressively worse, and he started having pain in his right knee as well.
But for the next 9 years, Tom says, he lived with the discomfort because the cost of knee replacement surgery seemed too high.
Then, Tom decided the pain was too much to bear, and he looked into his benefit package, where discovered an add-on benefit. He found out that his Carrum Health benefit, a benefit his company provided on top of his health insurance, covered high-cost, complex treatments such as surgery and cancer care. And after he looked into it further, he realized it would cover the cost of both knee replacements.
Through Carrum, Tom was matched with a surgeon 3 hours away in Charlotte, North Carolina, who performed both of his knee replacements. The surgeries were done at no out-of-pocket cost to him. Even car rental and incidentals were covered, he says.
After the surgeries, Tom quickly regained mobility and now enjoys an active lifestyle.
“I’m a new man,” he says. “I have such a good feeling about waking up every day. I’m up and down stairs. I’m doing 15,000 steps minimum a day on my Fitbit — sometimes, 20,000 when we’re busy catering. I feel amazing, truly.”
What does the doctor say?
Patricia Pinto-Garcia, MD, MPH
Senior Medical Editor
Total knee arthroplasty — or knee replacement surgery — is a major surgical procedure.
Like other major surgeries, it takes time and determination to fully recover from a knee replacement. It’s important to strike the right balance between working through discomfort and listening to your body so you can take it easy when the pain is too much. Pain, after all, is your body’s way of telling you that something is wrong, and it’s important to heed that warning. But at the same time, sticking to your exercise and physical therapy routine can help you get the best results and regain movement and mobility.
Your healthcare team plays an important role in helping you find that balance — not just right after surgery but also in the weeks and months that follow.
Studies show most people are happy with their decision to undergo knee replacement surgery. But experts also point out that a person’s expectations are a big predictor of whether they’ll be satisfied with their procedure. People tend to have a more positive outlook when they know to expect pain after the surgery and a step-wise return to full mobility.
While some people expect they’ll be able to resume their regular routine after a knee replacement, the reality is that most need assistive devices — like canes and walkers — for some time afterward. Regaining full mobility can take up to a year, and sometimes longer if there are complications. So you’ll need determination, diligence, and patience to get through recovery. But in the long term, the surgery can help you get back to the activities you love, and for many people, that makes it worthwhile
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