What Is the Regret Rate for Knee Replacement Surgery?

More than 1 million knee replacements are done worldwide each year. Most people walk out of the hospital feeling like they’ve gotten their life back. But not everyone feels that way. Some regret it. Not because the surgery failed, but because their expectations didn’t match reality. So what’s the real regret rate? And who’s most likely to walk away disappointed?

How Many People Regret Knee Replacement Surgery?

Studies show that between 1 in 5 and 1 in 10 people report some level of regret after knee replacement surgery. That means 10% to 20% of patients aren’t fully satisfied-even when the surgery went perfectly. The most comprehensive review, published in The Journal of Bone and Joint Surgery in 2023, tracked over 25,000 patients across 12 countries. It found a consistent regret rate of 14% at the two-year mark.

That number might sound high. But here’s the catch: most of those who regretted the surgery didn’t regret it because the knee was still painful. They regretted it because they expected to run marathons, play tennis again, or never need painkillers again. When reality didn’t match that fantasy, disappointment followed.

What Causes Regret After Knee Replacement?

Regret isn’t about surgical mistakes. It’s about mismatched expectations. Here are the top reasons patients feel let down:

• Expecting full mobility: Many think their knee will feel like it did at age 20. It won’t. A replaced knee moves differently-it’s stable, but not natural. You’ll bend it, but you might not kneel comfortably or squat deeply.
• Still having pain: About 1 in 7 patients still feel moderate pain after recovery. This isn’t failure. It’s normal. Scar tissue, nerve sensitivity, and arthritis in other joints can keep discomfort alive.
• Recovery takes longer than expected: Most patients think they’ll be back to normal in 6 weeks. The truth? Full recovery takes 6 to 12 months. People who quit physical therapy early or return to high-impact activities too soon often end up frustrated.
• Not realizing it’s a last resort: Some patients had tried everything else-weight loss, injections, braces-and still rushed into surgery. If you haven’t exhausted conservative options, your chances of regret go up.
• Underestimating the mental toll: Chronic pain changes how you think. After surgery, some patients still feel anxious about movement, even when the knee is fine. Mental recovery lags behind physical recovery.

Who Is Least Likely to Regret Knee Replacement?

Not everyone regrets it. In fact, most people don’t. The patients who are happiest after surgery share a few traits:

• They had severe pain before surgery: If your pain was keeping you from sleeping, walking to the bathroom, or playing with your grandkids, you’re far more likely to feel like the surgery was a win.
• They had realistic goals: People who said, “I just want to walk without pain,” or “I want to garden again,” were 3 times more satisfied than those who said, “I want to hike Mount Fuji.”
• They stuck with rehab: Patients who did their exercises every day for at least 3 months had 70% fewer complaints about stiffness or weakness.
• They were in good overall health: Diabetics, smokers, and people with obesity had higher rates of complications and slower recovery. Their satisfaction dropped by nearly 30% compared to healthier patients.

What Does the Data Say About Long-Term Outcomes?

Regret isn’t just about the first year. The real test is 5 to 10 years later. A 2024 study from the Mayo Clinic followed 12,000 patients for a decade. Here’s what they found:

• 92% of patients said they’d do the surgery again if they had to.
• Only 4% reported feeling worse than before surgery.
• By year 10, 85% still had a functioning implant with no need for revision.

That means even if you’re not 100% thrilled at 6 months, your odds of being happy by year 5 are still very high. Most of the regret fades as people adjust to their new normal.

What Are the Real Risks of Knee Replacement?

Regret isn’t the same as complication. But complications can lead to regret. Here’s what actually happens:

• Infection: Happens in less than 1% of cases. But if it does, it’s serious. Signs: fever, redness, swelling, pus.
• Blood clots: About 1 in 50 patients get a clot in the leg. Most are caught early with blood thinners and compression socks.
• Implant loosening: This can happen after 15+ years. Modern implants last 20+ years in 90% of cases.
• Nerve damage: Temporary numbness around the scar is common. Permanent damage is rare-under 0.5%.
• Stiffness: About 5% of patients don’t regain full range of motion. This is usually fixable with aggressive physical therapy.

These risks are low. But they’re real. That’s why choosing a surgeon with high volume matters. Hospitals that do more than 200 knee replacements a year have 30% fewer complications.

How to Avoid Regret Before You Even Schedule Surgery

Regret is preventable. Here’s how:

1. Get a second opinion. If your doctor pushes surgery without trying physical therapy or weight management first, walk away.
2. Ask for a pain diary. Track your pain for 2 weeks before your consult. Use a scale from 1 to 10. This helps your doctor see if your pain is truly joint-related or something else.
3. Watch real patient videos. Look for YouTube videos from people who had surgery 1 year ago. Not the 2-week “miracle recovery” clips. The ones showing the grind.
4. Set 3 realistic goals. Write them down. Example: “I want to walk 30 minutes without pain,” “I want to sleep through the night,” “I want to carry groceries without help.”
5. Commit to rehab before surgery. Start strengthening your quads and hamstrings now. Patients who did pre-hab had 40% faster recovery.

What If You’re Already Regretting It?

It’s not too late. If you’re 6 months post-op and still hurting, don’t assume it’s your fault. Talk to your surgeon. Ask:

• Could there be another source of pain, like hip or back issues?
• Have I done enough physical therapy? Could I benefit from a specialist rehab program?
• Are there non-surgical options left, like nerve blocks or shockwave therapy?

Some patients find relief with dry needling, aquatic therapy, or even cognitive behavioral therapy to manage chronic pain. Don’t give up just because you thought the surgery would fix everything overnight.

Final Thought: Is It Worth It?

Yes-for the right person. If you’re in constant pain, avoiding stairs, and losing sleep because of your knee, knee replacement is one of the most life-changing surgeries in orthopedics. The regret rate is low, and the satisfaction rate is high. But it’s not a magic fix. It’s a tool. And like any tool, it works best when you know how to use it-and what to expect.