Happy - the surgeon makes a small cut into the quadriceps muscle to release the patella. This isn't terribly painful after surgery, usually only noticeable to the touch. It heals quickly.

One thing I didn't expect was the extensive bruising on my inside thigh that showed up after 3 or 4 days. The reason - they put a very tight tourniquet around the thigh to minimize bleeding inside the knee capsule during surgery. Makes sense and it didn't hurt much. But when my inner thigh turned red I was concerned with infection. I just wish they had told me to expect this. It's ugly but not a big deal and goes away quickly.