@gravity3

Good advice. Here is my version of it:

I came out of a TKR with no meaningful pain. I break up the credit this way: 5% for me for my detailed research on types of knee replacement and surgeons; 5% for mother nature (luck) and 90% for my incredible surgeon.

No matter how good the surgeon, that 5% for luck can creep in with bad luck. But finding a great surgeon using the best methods can maximize one's chance of a successful and pain free or pain minimized procedure.

I had a rare bicruciate retaining implant ("BCR"). Probably somewhere north of 95% of knee replacement surgeries involve cutting and removing the ACL. A BCR retains and protects the ACL but it is much more complex surgery. A BCR can only be done if the surgeon can determine once the knee is open that the ACL is sufficiently strong.

Athletes tend to prefer BCRs as they give a more natural feeling. But I wouldn't do one unless my surgeon was very experienced doing them (mine is) as the surgery is more complex.

If you can find a surgeon who does a subvastus or mini midvastus method, does not use a tourniquet, and does a Functional Alignment (or at least a kinematic or inverse kinematic alignment) and has done these a lot, you have given yourself the best chance of success.