A total knee replacement (TKR) is a major surgery that involves removing damaged parts of the knee joint and replacing them with artificial components. The pain after this surgery can be intense for several reasons. First, the procedure itself involves significant disruption to the knee’s soft tissues, bones, ligaments, and muscles. These structures are cut or altered to make space for the new joint, leading to inflammation and soreness post-surgery.

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Secondly, after a TKR, there’s a process of healing where the body works to repair the tissues that were affected. Swelling and bruising are common during the healing process, and these can contribute to the pain and discomfort. Nerves that were impacted during the procedure can also take time to recover, and this may cause sharp or persistent pain.

Another factor is the body's natural response to surgery. The immune system reacts to the presence of an artificial implant, leading to the release of chemicals like prostaglandins that can increase pain sensitivity. Moreover, physical therapy, which is necessary to regain strength and mobility in the knee, can also be painful as it pushes the knee through movements and stretches that it wasn’t able to do before.

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