@cyndi2013
Everyone heals differently. Our surgeons have varying skill levels and used different methods. Recovery is not one size fits all. Even the most basic total knee replacement involves cutting open the leg and cutting off the end of both the femur and tibia and then removing the ACL and perhaps the PCL as well. A traditional method will also involve cutting the tendon and muscle to gain access and then sewing them back at the conclusion of the procedure. Traditional TKRs will also involve using a tourniquet to control blood. The traditional technique creates greater trauma and the tourniquet creates recovery pain for around a month in many cases.

I had a very successful recovery with no post surgery pain. Here is what my extraordinary surgeon did:
1) used a minimally invasive mid vastus method which involves going under the tendon and through the muscle fibers;
2) Did not use a tourniquet but instead used tranexamic acid to control blood;
3) Used a robot (CORI) for added precision;
4) Put in a bicruciate retaining implant (BCR). In a BCR the ACL and PCL are retained and protected but BCRs are done in less than 1% of all total knee replacements. It is a very rare procedure and the surgery is more complex;
5) Corrected my severe misalignment with a Functional alignment. A Functional alignment attempts to match the natural alignment of the patient, not an arbitrary straight-line;
6) Did a plastic surgery close.

Importantly, my surgeon is vastly experienced at doing all of the above and I believe that this experience is critical. There is actually a video on the internet of my surgeon doing exactly my procedure in 2020 at an orthopedic innovations conference. I wanted a BCR but would not have agreed to having it done unless my surgeon had this experience.

Finally, my surgeon has been using a recovery protocol for some time that is similar to the Hospital for Special Surgery's new Quiet Knee protocol. He had me essentially resting the first two weeks while using an ice machine regularly for cooling and compression to bring down the inflammation in the knee before starting PT. I didn't appear to lose anything by waiting as my therapist measured my ROM at 122 in that third week and my extension as flat.